Application of enhanced recovery after surgery in intravenous fluid infusion after renal transplantation

Abstract

Objective To explore the application of enhanced recovery after surgery (ERAS) in intravenous fluid infusion after renal transplantation. Methods The clinical data of 124 renal transplantation recipients in the First Hospital Affiliated to Army Medical University were retrospectively analyzed. The recipients were divided into group A, group B and group C. The 24-hour intravenous fluid infusion was 2 500 -<4 000 mL in group A, and the recipients took fluids 6 hours after the surgery. The 24-hour intravenous fluid infusion was 4 000-6 000 mL in group B, and the recipients took fluids after anus exhaust. The 24-hour intravenous fluid infusion was more than 6 000 mL in group C, and the recipients took fluids after anus exhaust. The indexes between the 3 groups including central venous pressure (CVP), heart rate, blood pressure, urine volume and blood glucose 1 week after renal transplantation, and serum creatinine 1 month after renal transplantation, and the mean time in intensive care unit and average length of stay were compared with one-way analysis of variance. The gender of recipients, type of donor kidney, and the incidence of hyperglycemia, delayed wound healing and delayed graft function (DGF) after transplantation between the 3 groups were compared with chi-square test. Results The serum creatinine of the recipients between the 3 groups 1 month after transplantation were (110±23), (114±22) and (118±22) μmol/L respectively, which had no statistic difference (F=1.19, P>0.05). The CVP, systolic pressure, urine volume and blood glucose of the recipients in group A 1 week after transplantation were all lower than group B and C (P all 0.05). The incidence of delayed wound healing of group A was lower than group C (χ2=7.303, P<0.017). Only 1 recipient in group C died of heart failure and pneumonedema. Conclusions ERAS was applied to recipients after renal transplantation. Taking fluids as soon as possible and reducing the amount of infusion in the situation of normotension or slight hypertension were conducive to reduce postoperative complications, and is beneficial to postoperative recovery. Key words: Enhanced recovery after surgery; Renal transplantation; Fluid infusion