Observational studyCritical care (London, England)2013
The effect of excess fluid balance on the mortality rate of surgical patients: a multicenter prospective study.
Observational study in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase IV, Multicentric, Prospective, Controlled, Randomized, Double Blind Study Comparing a Crystalloid to a Colloid Used in the Perioperatory Hemodynamic Optimisation With a 'Closed Loop' Automatic Filling System, on the Post-surgery Morbidity in Major Abdominal Surgery.
A Pragmatic Multi-center Trial of Goal-directed Fluid Management Based on Pulse Pressure Variation Monitoring During High-risk Surgery
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incorporating Dynamic Assessment of Fluid Responsiveness Into Goal-Directed Therapy: A Systematic Review and Meta-Analysis.Critical care medicine · 2017Pooled it
- Influence of 3% Hypertonic Saline Versus 0.9% Saline on Intraoperative Maintenance Fluid Requirements in Adult Patients Undergoing Major Open Abdominal Surgeries: Randomized Controlled Study.World journal of surgery · 2022Trial
- A pragmatic multi-center trial of goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery.BMC anesthesiology · 2017Trial
- Trial
- A pilot study on reparixin, a CXCR1/2 antagonist, to assess safety and efficacy in attenuating ischaemia-reperfusion injury and inflammation after on-pump coronary artery bypass graft surgery.Clinical and experimental immunology · 2015Trial
- Association between intraoperative fluid volume and 30-day mortality in patients undergoing lung transplantation: a retrospective cohort study.Journal of thoracic disease · 2026Article
- Incidence of intra-abdominal hypertension after liver transplantation with temporary portocaval shunt - A prospective cohort.Clinics (Sao Paulo, Brazil) · 2026Article
- Postoperative pulmonary complications of desflurane- versus sevoflurane-based general anesthesia in patients with chronic obstructive pulmonary disease or asthma undergoing gastrointestinal cancer surgery: a nationwide retrospective cohort study.Journal of anesthesia · 2026Article
- Perioperative fluid accumulation and clinical outcomes after cardiac surgery: a systematic review and Bayesian meta-analysis.Journal of anesthesia, analgesia and critical care · 2026Review
- Complication patterns and postoperative outcomes in surgical patients admitted to intensive care units.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Fluid management strategies in critically ill patients with ARDS: a narrative review.European journal of medical research · 2025Review
- Venous excess ultrasound score association with acute kidney injury in critically ill patients: a systematic review and meta-analysis of observational studies.The ultrasound journal · 2025Review
- Optimal fluid management for the surgical intensive care unit patient.Critical care science · 2025Article
- Preoperative carbohydrate volume optimization in ERAS-guided minimally invasive gastrectomy: a single-blinded RCT assessing gastric residuals and metabolic safety profiles.Frontiers in surgery · 2025Article
- Intra-abdominal sepsis in critically ill surgical patients: the relationship between cumulative fluid balance and serum sodium and chloride levels and in-hospital mortality.Frontiers in medicine · 2025Article
- A Risk Prediction Nomogram Model for Postoperative Pulmonary Complications in Children Aged 0-6 years.Risk management and healthcare policy · 2025Article
- ARISCAT and LAS VEGAS risk scores for predicting postoperative pulmonary complications after cardiac surgery: a cohort study.Annals of medicine and surgery (2012) · 2024Article
- Postoperative complications and determinant of selecting non intracorporeal urinary diversion in patients undergoing robot-assisted radical cystectomy: an initial experience.Translational cancer research · 2024Article
- Acute kidney injury after radical gastrectomy: incidence, risk factors, and impact on prognosis.Gastroenterology report · 2024Article
- A preoperative ultrasound-based protocol for optimisation of fluid therapy to prevent early intraoperative hypotension: a randomised controlled study.Perioperative medicine (London, England) · 2023Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn some studies including small populations of patients undergoing specific surgery, an intraoperative liberal infusion of fluids was associated with increasing morbidity when compared to restrictive strategies. Therefore, to evaluate the role of excessive fluid infusion in a general population with high-risk surgery is very important. The aim of this study was to evaluate the impact of intraoperative fluid balance on the postoperative organ dysfunction, infection and mortality rate.
methodsWe conducted a prospective cohort study during one year in four ICUs from three tertiary hospitals, which included patients aged 18 years or more who required postoperative ICU after undergoing major surgery. Patients who underwent palliative surgery and whose fluid balance could change in outcome were excluded. The calculation of fluid balance was based on preoperative fasting, insensible losses from surgeries and urine output minus fluid replacement intraoperatively.
resultsThe study included 479 patients. Mean age was 61.2 ± 17.0 years and 8.8% of patients died at the hospital during the study. The median duration of surgery was 4.0 (3.2 to 5.5) h and the value of the Simplified Acute Physiology Score (SAPS) 3 score was 41.8 ± 14.5. Comparing survivors and non-survivors, the intraoperative fluid balance from non-survivors was higher (1,950 (1,400 to 3,400) mL vs. 1,400 (1,000 to 1,600) mL, P <0.001). Patients with fluid balance above 2,000 mL intraoperatively had a longer ICU stay (4.0 (3.0 to 8.0) vs. 3.0 (2.0 to 6.0), P <0.001) and higher incidence of infectious (41.9% vs. 25.9%, P = 0.001), neurological (46.2% vs. 13.2%, P <0.001), cardiovascular (63.2% vs. 39.6%, P <0.001) and respiratory complications (34.3% vs. 11.6%, P <0.001). In multivariate analysis, the fluid balance was an independent factor for death (OR per 100 mL = 1.024; P = 0.006; 95% CI 1.007 to 1.041).
conclusionsPatients with excessive intraoperative fluid balance have more ICU complications and higher hospital mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.