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Open Access 01-12-2019 | Esophagus Resection | Research article

Perioperative fluid dynamics evaluated by bioelectrical impedance analysis predict infectious surgical complications after esophagectomy

Authors: Shuichiro Oya, Hiroharu Yamashita, Ryohei Iwata, Koichiro Kawasaki, Asami Tanabe, Koichi Yagi, Susumu Aikou, Yasuyuki Seto

Published in: BMC Surgery | Issue 1/2019

Abstract

Background

Transthoracic esophagectomy, among the most invasive surgeries, is highly associated with postoperative infectious complications which adversely affect postoperative management including fluid dynamics. The aim of the study is to evaluate the utility of perioperative bioelectrical impedance analysis (BIA) measurements for the patients after transthoracic esophagectomy.

Method

Multi-frequency BIA measurements were conducted in 24 patients undergoing transthoracic esophagectomy preoperatively, at 1 h after surgery, and twice daily for the following 7 days. The amounts of extracellular water (ECW), internal cellular water (ICW), total body water (TBW), and fat-free mass (FFM) were calculated. Changing trends in variables were analyzed, and the patients were subdivided according to the presence of infectious surgical adverse events to identify differences in fluid dynamics.

Results

ECW was the major body fluid compartment showing an increase after surgery, and peaked on postoperative day (POD) 2. Twelve patients experienced infectious complications. The peaks of changes in ECW and ECW/TBW appeared earlier and their values at the highest peak were significantly lower in the group without infectious complications on POD 2. The ICW/FFM value showed a mild decrease as compared to POD1 and then gradually recovered. It was significantly lower even before surgery and showed the most significant stratification on POD2. ECW/TBW of 48% and ICW/FFM of 37% on POD2 were predictive cut-off values for infectious adverse events with high area-under receiver operating characteristic (ROC) curves: 0.80 or higher.

Conclusion

BIA measurements are useful for monitoring fluid retention and may predict infectious complications in the early phase after transthoracic esophagectomy.

Trial registration

Registry name: UMIN-CTR, ID: UMIN000030734, Registered on January 9, 2018, retrospectively registered.

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Title: Perioperative fluid dynamics evaluated by bioelectrical impedance analysis predict infectious surgical complications after esophagectomy
Authors: Shuichiro Oya
Hiroharu Yamashita
Ryohei Iwata
Koichiro Kawasaki
Asami Tanabe
Koichi Yagi
Susumu Aikou
Yasuyuki Seto
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Esophagus Resection
Esophagus Resection
Published in: BMC Surgery / Issue 1/2019
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-019-0652-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perioperative fluid dynamics evaluated by bioelectrical impedance analysis predict infectious surgical complications after esophagectomy

Abstract

Background

Method

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Trial registration

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