Evidence map›Paper›PMID 29234998›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018

Reduction of Cardiopulmonary/Renal Complications with Serum BNP-Guided Volume Status Management in Posthepatectomy Patients.

Sameer H Patel, Bradford J Kim, Ching-Wei D Tzeng, Yun Shin Chun, Claudius Conrad, Jean-Nicolas Vauthey, Thomas A Aloia

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Enhanced Recovery After Surgery: Hepatobiliary.The Surgical clinics of North America · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Sameer H PatelDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Bradford J KimDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Ching-Wei D TzengDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Yun Shin ChunDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Claudius ConradDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Jean-Nicolas VautheyDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA.
Thomas A AloiaDepartment of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6000, Houston, TX, 77230-1402, USA. TAAloia@mdanderson.org.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
TRAINING OF ACADEMIC SURGICAL ONCOLOGISTST32CA009599 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Ashley M Holder, Jennifer A. Wargo · 1988 to 2026
$13.2M
NIH INTRAMURAL NRSA INSTITUTIONAL TRAINING PROGRAMF35HD007939 · NICHD · U.S. NATIONAL INST/CHILD HLTH/HUMAN DEV · PI MERIC-BERNSTAM, FUNDA · 1994 to 1995
–
NCI NIH HHS P30 CA016672NCI NIH HHS T32 CA009599NICHD NIH HHS F35 HD007939
6 · The paper itself

Abstract

backgroundAfter hepatectomy, over- and under-resuscitations induce cardiopulmonary complications and acute kidney injury, respectively, leading to significant perioperative morbidity and mortality. Unlike serum chemistries or urine output, serum brain natriuretic peptide (BNP) levels have been shown to accurately reflect current intravascular fluid balance without influence from alterations of hormonal axes. Based on these data, this study was designed to measure the impact of a serum BNP-guided hepatobiliary fluid protocol on the incidence of posthepatectomy cardiopulmonary/renal complications.

methodsHepatectomy patients registered in a single-institution American College of Surgeons-National Surgical Quality Improvement Program database between 2011 and 2016 were examined in real time for the development of cardiopulmonary/renal complications and divided into pre- (2011-2013) and postimplementation (2014-2016) of a BNP-guided hepatobiliary fluid protocol groups. In the postimplementation group, maintenance fluids were tapered on a set protocol. Bolus fluids, diuresis, and micro-adjustments in fluid rate were guided by daily BNP values.

resultsFour hundred sixty patients underwent hepatectomy in the study period with 251 patients in the pre- and 209 patients in the postprotocol implementation groups. Cardiopulmonary/renal complication rates were 4.0% in the preprotocol group and reduced to 0.9% after initiation of the BNP-guided hepatobiliary fluid protocol (p = 0.04).

conclusionsDespite low event rates, these data suggest that goal-directed postoperative fluid therapy with the combination of a hepatobiliary fluid protocol and serum BNP-guided volume management is superior to traditional chemistry and bedside volume assessment and can reduce posthepatectomy cardiopulmonary and renal complications.

Indexed as

Acute Kidney InjuryAdultAgedAged, 80 and overBiomarkersCardiovascular DiseasesFemaleFluid TherapyHepatectomyHumansLung DiseasesMaleMiddle AgedNatriuretic Peptide, BrainPostoperative ComplicationsWater-Electrolyte BalanceBiomarkersNatriuretic Peptide, BrainBrain natriuretic peptide (BNP)CardiopulmonaryComplicationsHepatectomyRenal

Identifiers

PMID29234998
PMCPMC5839990
OpenAlexW2763305558

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.