Importance of intraoperative oliguria during major abdominal surgery: findings of the Restrictive versus Liberal Fluid Therapy in Major Abdominal Surgery trial.

@article{Myles2019ImportanceOI,
  title={Importance of intraoperative oliguria during major abdominal surgery: findings of the Restrictive versus Liberal Fluid Therapy in Major Abdominal Surgery trial.},
  author={Paul S. Myles and David R McIlroy and Rinaldo Bellomo and Sophie K A Wallace},
  journal={British journal of anaesthesia},
  year={2019},
  volume={122 6},
  pages={
          726-733
        }
}
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TLDR
It is demonstrated that intraoperative oliguria does not predict postoperative AKI in major abdominal surgery in a cohort of patients submitted to electivemajor abdominal surgery.
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References

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Intraoperative oliguria predicts acute kidney injury after major abdominal surgery
TLDR
Among patients undergoing major abdominal surgery, intraoperative oliguria <0.3 ml kg -1 h -1 was significantly associated with increased risk of postoperative AKI.
Association Between Intraoperative Oliguria and Acute Kidney Injury After Major Noncardiac Surgery
TLDR
It is found that intraoperative oliguria is associated with the incidence of AKI after major noncardiac surgery.
Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery
TLDR
Among patients at increased risk for complications during major abdominal surgery, a restrictive fluid regimen was not associated with a higher rate of disability‐free survival than a liberal fluid regimen and was associated with an increased rate of acute kidney injury.
Intraoperative permissive oliguria - how much is too much?
TLDR
The nature and impact of intraoperative oliguria or ‘permissive oliguria’ in anaesthetised patients undergoing elective surgery depends on patient characteristics and clinical conditions, and may not necessarily be associated with postoperative AKI.
Restrictive versus liberal fluid therapy in major abdominal surgery (RELIEF): rationale and design for a multicentre randomised trial
TLDR
The RELIEF trial is a pragmatic, multicentre, randomised, controlled trial evaluating perioperative fluid replacement in major abdominal surgery and the primary outcome is disability-free survival at 1 year after surgery.
Targeting oliguria reversal in perioperative restrictive fluid management does not influence the occurrence of renal dysfunction: A systematic review and meta-analysis
TLDR
It is suggested that, even though event numbers are small, perioperative restrictive fluid management does not increase oliguria or postoperative ARF while decreasing intraoperative fluid intake, irrespective of targeting reversal of oliguriaor not.
Effect of the volume of fluids administered on intraoperative oliguria in laparoscopic bariatric surgery: a randomized controlled trial.
TLDR
In patients undergoing laparoscopic bariatric surgery, intraoperative urine output is low regardless of the use of relatively high-volume fluid therapy, and the results suggest that the common practice to administer intraoperative fluids in response to low urine output should be reconsidered.
The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database
TLDR
Oliguria is common in ICU patients and may have a relatively benign nature if only transient, but the duration of oliguria and need for RRT are associated with worse outcome.
Preoperative optimization of the high‐risk surgical patient
TLDR
The role of inadequate tissue perfusion and DO2 in the development of complications after major surgery, the results of trials of preoperative interventions that aim to improve cardiac function and hence DO2, developments in the identification of patients who are most likely to benefit from these interventions and the role of fluids and inotropes in optimization strategies are reviewed.
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