• Birgitte Brandstrup, Hanne Tønnesen, Randi Beier-Holgersen, Else Hjortsø, Helle Ørding, Karen Lindorff-Larsen, Morten S Rasmussen, Charlotte Lanng, Lene Wallin, Lene H Iversen, Christina S Gramkow, Mette Okholm, Tine Blemmer, Poul-Erik Svendsen, Henrik H Rottensten, Birgit Thage, Jens Riis, Inge S Jeppesen, Dorthe Teilum, Anne Mette Christensen, Ben Graungaard, Frank Pott, and Danish Study Group on Perioperative Fluid Therapy.
• Clinical Unit of Preventive Medicine and Health Promotion, H:S Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. bbrandstrup@hotmail.com
• Ann. Surg. 2003 Nov 1;238(5):641-8.

ObjectiveTo investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection.Summary Background DataCurrent fluid administration in major surgery causes a weight increase of 3-6 kg. Complications after colorectal surgery are reported in up to 68% of patients. Associations between postoperative weight gain and poor survival as well as fluid overload and complications have been shown.MethodsWe did a randomized observer-blinded multicenter trial. After informed consent was obtained, 172 patients were allocated to either a restricted or a standard intraoperative and postoperative intravenous fluid regimen. The restricted regimen aimed at maintaining preoperative body weight; the standard regimen resembled everyday practice. The primary outcome measures were complications; the secondary measures were death and adverse effects.ResultsThe restricted intravenous fluid regimen significantly reduced postoperative complications both by intention-to-treat (33% versus 51%, P = 0.013) and per-protocol (30% versus 56%, P = 0.003) analyses. The numbers of both cardiopulmonary (7% versus 24%, P = 0.007) and tissue-healing complications (16% versus 31%, P = 0.04) were significantly reduced. No patients died in the restricted group compared with 4 deaths in the standard group (0% versus 4.7%, P = 0.12). No harmful adverse effects were observed.ConclusionThe restricted perioperative intravenous fluid regimen aiming at unchanged body weight reduces complications after elective colorectal resection.

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