SynthesisCritical care (London, England)2021
Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery.
Synthesis in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Effect of enhanced recovery after surgery on the rehabilitation of patients undergoing laparoscopic pancreaticoduodenectomy: A meta-analysis.Langenbeck's archives of surgery · 2026Pooled it
- Effect of restrictive versus liberal fluid therapy for laparoscopic gastric surgery on postoperative complications: a randomized controlled trial.Journal of anesthesia · 2025Trial
- Impact of the fluid challenge infusion rate on cardiac stroke volume during major spinal neurosurgery: a prospective single center randomized interventional trial.BMC anesthesiology · 2022Trial
- 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
- Development and internal validation of a clinical nomogram for predicting major postoperative pulmonary complications following radical cystectomy: a retrospective cohort study.Translational andrology and urology · 2026Article
- Association Between Adherence to a Locally Adapted Enhanced Recovery After Surgery Pathway and Perioperative Outcomes After Open Abdominal Aortic Aneurysm Repair: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Restrictive Versus Liberal Fluid Strategy for Initial Resuscitation in Sepsis and Septic Shock: A Systematic Review and Meta Analysis.Journal of clinical medicine research · 2026Article
- Prospective Assessment of Clinically Relevant Fluid Balance Thresholds Associated With Postoperative Complications in Advanced Ovarian Cancer.Acta anaesthesiologica Scandinavica · 2025Observational
- Perioperative fluid therapy impairs lymphatic pump function in male rats.Physiological reports · 2025Article
- Conservative fluid resuscitation protocol does not reduce the incidence of reoperation for bleeding after emergency CABG.Scientific reports · 2024Observational
- Impact of perioperative fluid overload on the occurrence of postoperative pulmonary complications following lobectomy.Journal of thoracic disease · 2024Article
- Effects of intraoperative different fluid therapy protocols on postoperative renal functions.BMC anesthesiology · 2024Observational
- Anaesthesia for pelvic exenteration surgery.BJA education · 2024Review
- Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice.Journal of clinical medicine · 2024Review
- High versus standard blood pressure target in hypertensive high-risk patients undergoing elective major abdominal surgery: a study protocol for the HISTAP randomized clinical trial.Journal of anesthesia, analgesia and critical care · 2023Article
- Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study.Journal of clinical monitoring and computing · 2023Article
- Review
- Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery.Journal of cardiovascular development and disease · 2023Article
- Advances of perioperative acute kidney injury in elderly patients undergoing non-cardiac surgery.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2023Article
- Pressure response to fluid challenge administration in hypotensive surgical patients: a post-hoc pharmacodynamic analysis of five datasets.Journal of clinical monitoring and computing · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative complications impact on early and long-term patients' outcome. Appropriate perioperative fluid management is pivotal in this context; however, the most effective perioperative fluid management is still unclear. The enhanced recovery after surgery pathways recommend a perioperative zero-balance, whereas recent findings suggest a more liberal approach could be beneficial. We conducted this trial to address the impact of restrictive vs. liberal fluid approaches on overall postoperative complications and mortality.
methodsSystematic review and meta-analysis, including randomised controlled trials (RCTs). We performed a systematic literature search using MEDLINE (via Ovid), EMBASE (via Ovid) and the Cochrane Controlled Clinical trials register databases, published from 1 January 2000 to 31 December 2019. We included RCTs enrolling adult patients undergoing elective abdominal surgery and comparing the use of restrictive/liberal approaches enrolling at least 15 patients in each subgroup. Studies involving cardiac, non-elective surgery, paediatric or obstetric surgeries were excluded.
resultsAfter full-text examination, the metanalysis finally included 18 studies and 5567 patients randomised to restrictive (2786 patients; 50.0%) or liberal approaches (2780 patients; 50.0%). We found no difference in the occurrence of severe postoperative complications between restrictive and liberal subgroups [risk difference (95% CI) = 0.009 (- 0.02; 0.04); p value = 0.62; I
trial registrationCRD42020218059; Registration: February 2020, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218059 .
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What OpenQuestion holds
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.