Perioperativ vaeskebehandling ved perforeret ulcus
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Perioperativ vaeskebehandling ved perforeret ulcus. / Bjerre, Catherine Collin; Holte, Kathrine.
In: Ugeskrift for læger, Vol. 171, No. 18, 2009, p. 1488-91.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Perioperativ vaeskebehandling ved perforeret ulcus
AU - Bjerre, Catherine Collin
AU - Holte, Kathrine
N1 - Keywords: Adult; Aged; Aged, 80 and over; Duodenal Ulcer; Female; Fluid Therapy; Humans; Intraoperative Care; Male; Middle Aged; Peptic Ulcer Perforation; Postoperative Care; Postoperative Complications; Preoperative Care; Retrospective Studies; Stomach Ulcer; Treatment Outcome
PY - 2009
Y1 - 2009
N2 - INTRODUCTION: Surgery for perforated ulcers is one of the most common emergency surgical procedures. Approximately 400 procedures are performed each year in Denmark and mortality is high, reaching close to 30% at 30 days postoperatively. The importance of perioperative fluid administration during the perioperative course remains unclear. The purpose of this study is to describe the perioperative fluid management in these patients in order to identify problem areas (if any) and to create a basis on which future trials on fluid management in this patient group may be designed. MATERIAL AND METHODS: Retrospective survey of 45 consecutive patients operated for perforated ulcers over a 3-year period between 1 January 2003 and 31 December 2005 in the surgical department of a university hospital. RESULTS: Data that would permit rational fluid therapy are not being collected on a regular basis. Fluid balance charts were kept for 42 patients on the day of operation (89%), for 29 patients on the first post-operative day (61%), for 17 patients on the second post-operative day (36%) and for 12 patients (25%) on the third post-operative day. No patients were weighed for assessment of fluid status. Perioperative fluid administration varied extensively, with fluid balance on the day of surgery ranging from -45 to 8,030 ml (median 2688 ml) and a cumulated fluid balance of 7,2 litres (1,875-14,565 ml) three days postoperatively. Generally, patients had no fluid administered prior to surgery (median 0 ml, applying to 41 patients (87%) range 0-4,500 ml). CONCLUSION: Both the preoperative fluid management and the postoperative monitoring of the fluid balance are suboptimal and should be optimized. Individualized (goal-directed) fluid administration aiming at optimizing the oxygen supply to the peripheral tissues is warranted and is recommended to high-risk emergency surgery patients. Udgivelsesdato: 2009-Apr
AB - INTRODUCTION: Surgery for perforated ulcers is one of the most common emergency surgical procedures. Approximately 400 procedures are performed each year in Denmark and mortality is high, reaching close to 30% at 30 days postoperatively. The importance of perioperative fluid administration during the perioperative course remains unclear. The purpose of this study is to describe the perioperative fluid management in these patients in order to identify problem areas (if any) and to create a basis on which future trials on fluid management in this patient group may be designed. MATERIAL AND METHODS: Retrospective survey of 45 consecutive patients operated for perforated ulcers over a 3-year period between 1 January 2003 and 31 December 2005 in the surgical department of a university hospital. RESULTS: Data that would permit rational fluid therapy are not being collected on a regular basis. Fluid balance charts were kept for 42 patients on the day of operation (89%), for 29 patients on the first post-operative day (61%), for 17 patients on the second post-operative day (36%) and for 12 patients (25%) on the third post-operative day. No patients were weighed for assessment of fluid status. Perioperative fluid administration varied extensively, with fluid balance on the day of surgery ranging from -45 to 8,030 ml (median 2688 ml) and a cumulated fluid balance of 7,2 litres (1,875-14,565 ml) three days postoperatively. Generally, patients had no fluid administered prior to surgery (median 0 ml, applying to 41 patients (87%) range 0-4,500 ml). CONCLUSION: Both the preoperative fluid management and the postoperative monitoring of the fluid balance are suboptimal and should be optimized. Individualized (goal-directed) fluid administration aiming at optimizing the oxygen supply to the peripheral tissues is warranted and is recommended to high-risk emergency surgery patients. Udgivelsesdato: 2009-Apr
M3 - Tidsskriftartikel
C2 - 19419626
VL - 171
SP - 1488
EP - 1491
JO - Ugeskrift for Laeger
JF - Ugeskrift for Laeger
SN - 0041-5782
IS - 18
ER -
ID: 20366870