"Systemic fluid volume management, postoperative critical care mortality and reduced complications
Oct 23, 2024
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A research team led by Kim Eun-young, a professor of intensive care trauma surgery at Catholic University of Korea's Seoul St. Mary's Hospital, suggested a systematic way to help patients recover through Bioelectrical Impedance Analysis (BIA) that can be used relatively easily in the medical field.
Bioelectrical impedance analysis is a test method that determines the composition of the body by measuring the resistance value (impedance) generated by flowing a weak current to the body. When water is insufficient in the body, dehydration occurs, and when water is excessive, swelling occurs, so it is known that moisture management is very important in patient recovery.
In particular, in the surgical process that directly affects life, a significant amount of fluid is administered to maintain blood pressure, and water imbalance in the body is likely to occur due to a wide range of systemic inflammatory reactions. However, many studies have been conducted so far on fluid therapy administered after initial resuscitation, but it is known that no clear guidelines exist for water management after surgery. Accordingly, the research team tried to improve clinical results by monitoring the fluid condition and systematically managing it using bioelectrical impedance analysis.
The study, conducted in a prospective single-blind, randomized controlled manner, was conducted between November 2021 and December 2022 by randomly dividing 200 patients who were admitted to the ICU after surgery into two groups.
Based on bioelectrical measurement data, the research team adjusted the amount of fluid based on the extracellular water (ECW) ratio. In the body fluid management group, which is an intervention group, crystalline solutions were administered to patients with dehydration, and diuretics were administered to patients with excessive body fluid until they fell within the normal range to carefully control body fluid volume within the normal range. On the other hand, in the control group, regardless of the measurement results, traditional treatment was performed in the same way as before.
As a result of the study, it was observed that the incidence of postoperative complications decreased significantly from 46.0% to 31.4% in patients (intervention groups) who received fluid volume management in the fruit tree state compared to patients (controls) treated in the conventional way. In terms of mortality, the 28-day mortality rate of patients undergoing fluid volume management was only 1.3%, significantly lower than the previous 14.4%, and the multivariate analysis Ods Ratio showed a large difference of about 9.9 times.
This study is the first clinical study to prove that fluid volume management using bioelectrical impedance analysis can improve treatment performance for intensive care unit patients after abdominal surgery, as well as setting a new criterion for solving the fluid imbalance problem. Accurate monitoring allows early detection and proper management of fruit tree conditions, which can speed up the patient's recovery and reduce the incidence of complications, ultimately improving the survival rate.
Professor Kim Eun-young of Intensive Care Trauma Surgery said, "This study is a meaningful result of demonstrating that active fluid volume management of surgical patients using bioelectrical impedance analysis can contribute to reducing mortality and complications. We will continue to work on various studies to improve intensive care treatment outcomes in the future."
Meanwhile, the study was recently published in the European Journal of Clinical Nutrition, a prominent international journal in the field of clinical nutrition.
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