PS01.180: IMPACT OF INTRAOPERATIVE FLUID MANAGEMENT ON POSTOPERATIVE CARDIOPULMONARY FUNCTION AFTER THORACIC ESOPHAGECTOMY: A RETROSPECTIVE COHORT STUDY

Abstract Background This study aims to investigate the impact of intraoperative infusion balance on postoperative hemodynamics and oxygenation in patients undergoing elective transthoracic esophagectomy. Although adequate volume control is often deemed imperative to reduce complications, definitions of practical infusion dosages for the fluid management during surgery are absent. Methods In this retrospective cohort study, we examined 200 patients who underwent transthoracic esophagectomy from 2008 to 2017. During anesthesia, we followed our protocol that recommends the infusion volume of 10 mL/kg/h. Postoperatively, we followed the postoperative fluid protocol (Kobayashi M. Dis Esophagus 2010 23:565–71). Then, we collected data on actual volume of water infused both intraoperatively and postoperatively, and also evaluated ratios of intrapulmonary shunting (Qs/Qt), the occurrence of hypotension, the necessity of fluid resuscitation, and postoperative complications. Results In this study, postoperative hypotension was more frequent in patients who required more amount of fluid during surgery than the amount anticipated per the protocol. In addition, we determined a correlation of the amount of fluid volume between during surgery and postoperative day 0 (P = 0.001)(Fig.1a). Notably, an increased amount of intraoperative fluid did not deteriorate Qs/Qt (Fig.1b) or elevate the risk of postoperative complications. Conclusion This study deduces that higher increase in the intraoperative infusion volume could predict postoperative variation in the circulation after esophagectomy. In addition, although postoperative hypotension readily caused more infused volume than the expected balance, overdosed infusion in POD 0 demonstrated no apparent correlation with the impairment of pulmonary function. Disclosure All authors have declared no conflicts of interest.