Postoperative abdominal bleeding

Tasu, J.P.; Vesselle, G.; Herpe, Guillaume; Ferrié, J.-C.; Chan, Paul S.; Boucebci, S.; Velasco, Stéphane

doi:10.1016/j.diii.2015.03.013

Cited by 35 publications

(24 citation statements)

References 27 publications

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“…Most major postoperative bleeding is due to surgical complications, which are presumably not influenced by fluids selection. 23 Furthermore, perioperative coagulopathy is mostly dilutional, irrespective of the fluid given. 24 Finally, patients with major blood loss are almost always given colloids, which themselves cause coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

Saline versus Lactated Ringer’s Solution

et al. 2020

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Background: Both saline and lactated Ringer's solutions are commonly given to surgical patients. However, hyperchloremic acidosis consequent to saline administration may provoke complications. The authors therefore tested the primary hypothesis that a composite of in-hospital mortality and major postoperative complications is less common in patients given lactated Ringer's solution than normal saline. Methods:The authors conducted an alternating cohort controlled trial in which adults having colorectal and orthopedic surgery were given either lactated Ringer's solution or normal saline in 2-week blocks between September 2015 and August 2018. The primary outcome was a composite of in-hospital mortality and major postoperative renal, respiratory, infectious, and hemorrhagic complications. The secondary outcome was postoperative acute kidney injury.results: Among 8,616 qualifying patients, 4,187 (49%) were assigned to lactated Ringer's solution, and 4,429 (51%) were assigned to saline. Each group received a median 1.9 l of fluid. The primary composite of major complications was observed in 5.8% of lactated Ringer's versus 6.1% of normal saline patients, with estimated average relative risk across the components of the composite of 1.16 (95% CI, 0.89 to 1.52; P = 0.261). The secondary outcome, postoperative acute kidney injury, Acute Kidney Injury Network stage I-III versus 0, occurred in 6.6% of lactated Ringer's patients versus 6.2% of normal saline patients, with an estimated relative risk of 1.18 (99.3% CI, 0.99 to 1.41; P = 0.009, significance criterion of 0.007). Absolute differences between the treatment groups for each outcome were less than 0.5%, an amount that is not clinically meaningful.conclusions: In elective orthopedic and colorectal surgery patients, there was no clinically meaningful difference in postoperative complications with lactated Ringer's or saline volume replacement. Clinicians can reasonably use either solution intraoperatively. (ANESTHESIOLOGY 2020; 132:614-24) What We Already Know about This Topic • Infusion of large volumes of saline causes hyperchloremic metabolic acidosis • A recent Cochrane review based on 18 small trials reported that major morbidity and mortality were comparable with perioperative saline or lactated Ringer's use What This Article Tells Us That is New• In a large single-center alternating cohort trial of patients having elective colorectal or orthopedic surgery, there was no clinically meaningful difference in the risk of a composite of in-hospital mortality and major postoperative complications including renal, respiratory, infectious, and hemorrhagic complications A bout 51 million inpatient surgeries were performed in the United States in 2010, based on National Hospital Discharge Survey. 1 Nearly all surgeries require intravenous crystalloid fluids for drug administration and vascular volume repletion. Saline (0.9% sodium chloride; "normal saline") is a commonly used crystalloid, but it has a much higher chloride concentration than human plasma, and is thus u...

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Section: Discussionmentioning

confidence: 99%

Saline versus Lactated Ringer’s Solution

et al. 2020

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“…Gastric juice and bile intestinal contents can be seen in abdominal drainage and this confirms the diagnosis combined with digestive tract iodine angiography [18,19]. Abdominal hemorrhage was defined when the progressive decrease of hemoglobin was more than 20 g/L in line with abdominal CT or color Doppler ultrasound [20]. Pulmonary infection was diagnosed when the body temperature > 37.5°C, white blood cell count >10 × 10 10 /L, and percentage of neutrophils >90% combined with chest X-ray or CT [21].…”

Section: Observation Indicators and Eirmentioning

confidence: 89%

Effect of Qihuang Decoction Combined with Enteral Nutrition on Postoperative Gastric Cancer of Nutrition and Immune Function

Zhou

Peng

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. Early nutritional support in patients with gastric cancer can improve their nutritional status, but the impact on immune function has not been confirmed. is study aimed to analyze the effects of Qihuang decoction combined with enteral nutrition on nutrition and the immune function of postoperative gastric cancer. Methods. 120 patients with postoperative gastric cancer in the study group and 117 in the control group were selected as the study subjects from our hospital at random. Indications of nutrition and immune and the rates of complications were compared the day before surgery and 1, 3, 7, and 14 days after surgery. Results. Indications of nutrition except hemoglobin (HB) in the study group were significantly higher than those before operation and the albumin (ALB) and prealbumin (TP) were significantly increased 7 and 14 days after surgery (P < 0.001 and P < 0.001 versus P < 0.001 and P < 0.001) and the protein (PA) 3, 7, and 14 days after surgery (P � 0.011, P � 0.002, and P � 0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3 + , CD4 + , and CD4 + /CD8 + were significantly increased 7 and 14 days after surgery (P � 0.027 and P < 0.001 versus P � 0.008 and P < 0.001 versus P � 0.010 and P < 0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group (P < 0.001, P < 0.001, and P < 0.001 versus P < 0.001, P < 0.002, and P < 0.001 versus P < 0.001, P < 0.001, and P < 0.001). e complications such as abdominal, lung, wound, and urinary infection were also significantly decreased (P χ 2 � 0.017; P χ 2 � 0.036; P χ 2 � 0.041; P χ 2 � 0.004). Conclusions. Qihuang decoction combined with enteral nutrition can promote the absorption of enteral nutrition with improving the immune and reducing complications of infection.

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“…Both CT and ultrasonography were determined as effective imaging methods in the diagnosis of hematoma (7). Although USG is inadequate in the diagnosis of the hematoma resulting from bleeding in solid organs, it is an effective method to diagnose hematoma caused by intra-abdominal bleeding (8). USG appears to be a frequently preferred method for the diagnosis of postoperative hematoma as it is an accessible, non-invasive and accurate diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Patients with Hematoma after Gynecologıc and Obstetric Surgery

Kahveci

Obut

Ege

et al. 2020

Gynecol Obstet Reprod Med

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Objective: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.Study Design: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and Research Hospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomy were not included. The diagnosed cases were divided into three groups as wound hematoma, rectus sheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases were assessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.Results: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years. Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p < 0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Fever was detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. In addition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiological drainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was 4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had wound hematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III: 2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitoneal hematoma. The mean hematoma size was 68.1±15.18 mm. Conclusions: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma, we can consider percutaneous catheter drainage as an alternative to surgical intervention.

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Postoperative abdominal bleeding

Cited by 35 publications

References 27 publications

Saline versus Lactated Ringer’s Solution

Saline versus Lactated Ringer’s Solution

Effect of Qihuang Decoction Combined with Enteral Nutrition on Postoperative Gastric Cancer of Nutrition and Immune Function

Evaluation and Management of Patients with Hematoma after Gynecologıc and Obstetric Surgery

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