The effects of different fluid therapies on volume expansion during abdominal surgery and its impacts on postoperative renal function

Objective To study the effects of different fluid therapies on the volume expansion during abdominal surgery and its impacts on the postoperative renal function.Methods According to the type of fluid therapy,316 patients in selective abdominal surgery were divided into three groups: Group A,B and C.The fluid therapies consisted of half of lactate Ringer's plus half of gelatin or hydroxyethyl starch,gelatin or hydroxyethyl starch only,and lactate Ringer's only were performed in Group A,B and C,respectively,with an infusion rate of 5 mL/(kg·h).However,infusion dosage was adjusted according to bleeding or hypotension.The HR,MAP,CVP,SpO2,surgical time,fluid dosage,bleeding and urine volume were monitored during surgery,while creatine and urea levels were measured pre-and postoperatively.Results The average infusion dosages during surgery were(7.2±3.2),(6.2±2.5)and(6.2±2.2)mL/(kg·h) in Group A,B and C respectively,while total infusion dosages were(1 418.1±605.1),(1 127.0±461.0)and(1 239.4 ±432.6)mL,respectively.Signficant higher average and total infusion dosages were observed in Group A than those in Group B and C(P0.05,P0.01).The HR and MAP during surgery were significantly lower than preanesthesia(P0.01).The CVP levels significantly increased during surgery in all groups(P0.01).The postoperative plasma creatine and urea levels were within normal range,whereas significant postoperative increase of creatine was observed in Group B(P0.01).Conclusion Circulatory volume can be maintained effectively by all the three types of fluid therapies in surgery with bleeding less than 300 mL.Furthermore,no renal function impairment occurs postoperatively.However,increased creatine level after surgery in Group B needs further concern.