Plasma pro-atrial natriuretic peptide to estimate fluid balance during open and robot-assisted esophagectomy: a prospective observational study
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Plasma pro-atrial natriuretic peptide to estimate fluid balance during open and robot-assisted esophagectomy : a prospective observational study. / Strandby, Rune Broni; Ambrus, Rikard; Secher, Niels H; Goetze, Jens Peter; Achiam, Michael Patrick; Svendsen, Lars Bo.
In: B M C Anesthesiology, Vol. 17, 20, 03.02.2017.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Plasma pro-atrial natriuretic peptide to estimate fluid balance during open and robot-assisted esophagectomy
T2 - a prospective observational study
AU - Strandby, Rune Broni
AU - Ambrus, Rikard
AU - Secher, Niels H
AU - Goetze, Jens Peter
AU - Achiam, Michael Patrick
AU - Svendsen, Lars Bo
PY - 2017/2/3
Y1 - 2017/2/3
N2 - BACKGROUND: It remains debated how much fluid should be administered during surgery. The atrial natriuretic peptide precursor proANP is released by atrial distension and deviations in plasma proANP are reported associated with perioperative fluid balance. We hypothesized that plasma proANP would decrease when the central blood volume is compromised during the abdominal part of robot-assisted hybrid (RE) esophagectomy and that a positive fluid balance would be required to maintain plasma proANP.METHODS: Patients undergoing RE (n = 25) or open (OE; n = 25) esophagectomy for gastroesophageal cancer were included consecutively in this prospective observational study. Plasma proANP was determined repetitively during esophagectomy to allow for distinction between the abdominal and thoracic part of the procedure. The RE group was 15° head up tilted during the abdominal procedure.RESULTS: The blood loss was 250 (150-375) (RE) and 600 ml (390-855) (OE) (p = 0.01), but the two groups of patients were provided with a similar positive fluid balance: 1705 (1390-1983) vs. 1528 ml (1316-1834) (p = 0.4). However, plasma proANP decreased by 21% (p < 0.01) during the abdominal part of RE carried out during moderate head-up tilt, but only by 11% (p = 0.01) during OE where the patients were supine. Plasma proANP and fluid balance were correlated in the RE-group (r = 0.5 (0.073-0.840), p = 0.02) and tended to correlate in the OE group (r = 0.4 (-0.045-0.833), p = 0.08).CONCLUSION: The results support that plasma proANP decreases when the central blood volume is compromised and suggest that an about 2200 ml surplus administration of crystalloid is required to maintain plasma proANP during esophagectomy.TRIAL REGISTRATION: Clinicaltrials.gov ( NCT02077673 ). Registered retrospectively February 12th2014.
AB - BACKGROUND: It remains debated how much fluid should be administered during surgery. The atrial natriuretic peptide precursor proANP is released by atrial distension and deviations in plasma proANP are reported associated with perioperative fluid balance. We hypothesized that plasma proANP would decrease when the central blood volume is compromised during the abdominal part of robot-assisted hybrid (RE) esophagectomy and that a positive fluid balance would be required to maintain plasma proANP.METHODS: Patients undergoing RE (n = 25) or open (OE; n = 25) esophagectomy for gastroesophageal cancer were included consecutively in this prospective observational study. Plasma proANP was determined repetitively during esophagectomy to allow for distinction between the abdominal and thoracic part of the procedure. The RE group was 15° head up tilted during the abdominal procedure.RESULTS: The blood loss was 250 (150-375) (RE) and 600 ml (390-855) (OE) (p = 0.01), but the two groups of patients were provided with a similar positive fluid balance: 1705 (1390-1983) vs. 1528 ml (1316-1834) (p = 0.4). However, plasma proANP decreased by 21% (p < 0.01) during the abdominal part of RE carried out during moderate head-up tilt, but only by 11% (p = 0.01) during OE where the patients were supine. Plasma proANP and fluid balance were correlated in the RE-group (r = 0.5 (0.073-0.840), p = 0.02) and tended to correlate in the OE group (r = 0.4 (-0.045-0.833), p = 0.08).CONCLUSION: The results support that plasma proANP decreases when the central blood volume is compromised and suggest that an about 2200 ml surplus administration of crystalloid is required to maintain plasma proANP during esophagectomy.TRIAL REGISTRATION: Clinicaltrials.gov ( NCT02077673 ). Registered retrospectively February 12th2014.
KW - Aged
KW - Atrial Natriuretic Factor/blood
KW - Esophagectomy/methods
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Robotics
KW - Water-Electrolyte Balance
U2 - 10.1186/s12871-017-0314-6
DO - 10.1186/s12871-017-0314-6
M3 - Journal article
C2 - 28159014
VL - 17
JO - BMC Anesthesiology
JF - BMC Anesthesiology
SN - 1471-2253
M1 - 20
ER -
ID: 193972394