title: Restricted intravenous fluid regimen reduces fluid redistribution of patients operated for abdominal malignancy.
abstract: OBJECTIVE
  Recent studies indicate that perioperative fluid restriction leads to better preserved clinical data as well as reduced complication rates. This study aimed to determine the probable mechanism of fluid restriction influence on the complication rate of patients undergoing gastrointestinal surgery for malignancy.
  
  
  METHODS
  Patients (n = 174) undergoing restricted fluid regimen (R group) or standard fluid regimen (S group) were included in this prospective, randomized trial over 16 months. Fluid distribution was determined by Bioelectrical Impedance Analyzer (BIA) and the difference between two groups was compared regarding complications and the relationship between complications and fluid distribution changes.
  
  
  RESULTS
  The restricted intravenous fluid regimen significantly reduced perioperative intravenous fluid volume. Weight gained in S group and was not significantly changed in R group after surgery, especially in POD2 (media; R vs. S; 61.17 vs. 65.40 kg, p = 0.017). The number of patients with postoperative complications was reduced in R group compared with in S group (34.5% vs. 47.8%, p = 0.076). Systemic complications were significantly reduced in R group (t = -5.895, p = 0.000). Patients with complications had an average of 1.6 complications in R group vs. 2.0 in S group (t = -1.345, p = 0.183). The multivariate analysis suggested that perioperative fluid distribution changes were associated with the development of postoperative complications.
  
  
  CONCLUSIONS
  Perioperative fluid restriction could effect on fluid distribution and reduce tissue and cellular edema, and further, could reduce postoperative complication rates.
authors.forename: Nan-Hai
authors.initials: NH
authors.lastname: Peng
authors.forename: Tao
authors.initials: T
authors.lastname: Gao
authors.forename: Yue-Ying
authors.initials: YY
authors.lastname: Chen
authors.forename: Feng-Chan
authors.initials: FC
authors.lastname: Xi
authors.forename: Juan-Juan
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Zhu
authors.forename: Wen-Kui
authors.initials: WK
authors.lastname: Yu
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D000368:Aged; D016009:Chi-Square Distribution; D002681:China; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D017097:Electric Impedance; D005260:Female; D018495:Fluid Shifts; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain