Evidence map›Paper›PMID 30806785›Full record

Observational studyJournal of anesthesia2019

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study.

Masaharu Nagae, Moritoki Egi, Nana Furushima, Masako Okada, Shohei Makino, Satoshi Mizobuchi

Registry-linked trialAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of anesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07189091 (Effect of Reduced Sodium Chloride in Fluid Creep and Maintenance Fluids in Critically Ill Adults), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 30% 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.

NCT07189091 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Reduced Sodium Chloride in Fluid Creep and Maintenance Fluids in Critically Ill Adults: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity Hospital, AntwerpRan2025 to 2028Enrolled640ConditionsCritical Care, Intensive Care, Fluid Accumulation, Fluid and Electrolyte Imbalance, Critical IllnessArmsGlucose 5% for fluid creep, NaCl 0.9% (normal saline) for fluid creep, PlasmaLyte as maintenance fluid, NaCl 0.3% in glucose 3.3% as maintenance fluid
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Masaharu NagaeDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan.
Moritoki EgiDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan. moriori@tg8.so-net.ne.jp.ORCID http://orcid.org/0000-0002-0099-3060
Nana FurushimaDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan.
Masako OkadaDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan.
Shohei MakinoDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan.
Satoshi MizobuchiDepartment of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, 650-0017, Japan.
Kobe University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients, we conducted retrospective before-after study in a tertiary teaching hospital.

methodsWe examined all adult patients admitted ICU after an elective operation for head and neck cancer, or esophageal cancer from February 2014 to January 2017. From February 2014 to July 2015, patients were administered hypotonic fluid (sodium; 35 mmol/L) as the National Institute for Health and Care Excellence (NICE) have recommended. From August 2015 to January 2017, patients were administered isotonic fluid (sodium; 140 mmol/L). We defined the incidence of delirium as the primary outcome. The delirium was defined as the Intensive Care Delirium Screening Checklist during the ICU stay ≥ 4. A propensity score-matched model was used to adjust confounders.

resultsAs postoperative intravenous maintenance fluid, hypotonic fluid was administered to 119 patients and isotonic fluid was administered to 92 patients. Among those total cohorts, the incidence of postoperative delirium in the hypotonic group was 21.8%, which was significantly higher than that (9.8%) in the isotonic group (p = 0.019). After propensity score matching, we selected 77 patients in each group. The incidence of delirium during the ICU stay in the hypotonic group was 26.0%, which was significantly higher than the incidence of 11.7% in the isotonic group (p = 0.023).

conclusionsIn this study, the use of postoperative hypotonic maintenance fluid was associated with a higher risk of postoperative delirium than that when isotonic maintenance fluid was used.

Indexed as

Administration, IntravenousAgedCritical CareDeliriumFemaleFluid TherapyHumansHyponatremiaHypotonic SolutionsIncidenceInfusions, IntravenousIsotonic SolutionsMaleMiddle AgedPostoperative PeriodRetrospective StudiesHypotonic SolutionsIsotonic SolutionsSodiumDeliriumFluid therapyHyponatremiaPostoperative periodSodium

Identifiers

PMID30806785
OpenAlexW2917769231

What OpenQuestion holds

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Read underepoch 390

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.