Infusion effect on postoperative intestinal failure

Purpose: improvement of the results of operative treatment in patients with emergency abdominal pathology by selecting the tactics of perioperative infusion therapy that would be optimum for postoperative bowel function recovery. Materials and methods. 52 surgical patients (28 men, 24 women, mean age 57.5±14 years) subjected to various emergency abdominal surgeries were studied. The patients were split into 2 groups. It was a prospective study; group affiliation was determined by randomization. In group 1 (n=29), balanced ionic solutions were used for perioperative infusion therapy. In group 2 (n=23), balanced ionic solutions were combined with synthetic colloids. The infusion therapy volume during operation was 2359 ml on average. To determine the bowel function during the postoperative period, comprehensive dynamic assessment of the gastrointestinal tract (GIT) status was undertaken, which included physical examination, intra-abdominal pressure (IAP) measurement, and ultrasound visualization of the intestinal wall condition; the dynamics of intestinal absorptive function and common laboratory tests were monitored. The level of intestinal failure during the postoperative period was determined based on assessment of the GIT condition and recommendations of the National Guidelines for Parenteral and Enteral Nutrition. Results. A strong significant correlation (r=1.000, P=0.01) between the volume of perioperative infusion therapy and the stage of postoperative intestinal failure was established. Conclusion. During performance of emergency surgeries, the volume of intra-operative infusion therapy rendered a direct influence on the postoperative bowel function. Optimization and application of a targeted corrective infusion therapy during the perioperative period promote earlier resolution of postoperative intestinal failure. © 2018, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved.