Impact of Various Fluid Volumes on Mechanical Ventilation Time, Hospitalization Duration, and Hospitalization Cost in Postoperative Patients with Left Ventricular Diastolic Dysfunction Undergoing Non-Cardiac Surgery

Abstract

Objective

To describe the effects of various fluid strategies on mechanical ventilation time and other outcomes in patients with diastolic dysfunction undergoing non-cardiac surgery.

Methods

After evaluation, 192 Intensive Care patients met the inclusion criteria. Based on infusion volume and fluid balance, we categorized patients into quartiles using two grouping methodologies. The first quartiles for total infusion volume on day one of ICU admission after surgery were as follows: Q1 ≤ 2.02 mL/kg/h; Q2 > 2.02 to 2.69 mL/kg/h; Q3 > 2.69 to 3.86 mL/kg/h; Q4 > 3.86 mL/kg/h. The second quartiles for fluid balance divided by actual body weight multiplied by the corresponding number of hours were as follows: G1 ≤ −0.07 mL/kg/h; G2 > −0.07 to 0.56 mL/kg/h; G3 > 0.56 to 1.54 mL/kg/h; G4>1.54 mL/kg/h. The primary outcome was mechanical ventilation time. The research utilized both univariate and multivariate negative binomial regression models.

Results

The fourth group (Q4 and G4) had a significant impact on mechanical ventilation time(P<0.05).There were also significant differences between Q4 or G4 and some other groups in terms of ICU time, ICU cost, total hospital time, and total hospital cost (P < 0.05).After negative binomial regression analysis,Q2 and Q4 were approximately 2.406 times (95% CI 1.153–5.017, P = 0.019) and 3.532 times (95% CI 1.812–6.883, P < 0.01) longer than Q1 respectively, when grouped by infusion volume, but there was no significant difference between G groups. And Q4 or G4 also differed significantly from other parameters of clinical outcomes (P < 0.05).

Conclusion

For patients admitted to the ICU following non-cardiac surgery with left ventricular diastolic dysfunction, the greater the fluid infusion or fluid balance, the greater the mechanical ventilation time, ICU or hospital time, and cost.

Keywords:

• fluid strategies
• left ventricular diastolic dysfunction
• non-cardiac surgery
• mechanical ventilation time
• perioperative period

Acknowledgments

We would like to acknowledge the hard and dedicated work of all the staff that implemented the intervention and evaluation components of the study.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

No external funding was received to conduct this study.