Administration of an Oral Hydration Solution Prevents Electrolyte and Fluid Disturbances and Reduces Readmissions in Patients With a Diverting Ileostomy After Colorectal Surgery: A Prospective, Randomized, Controlled Trial.
Dis Colon Rectum
; 61(7): 840-846, 2018 Jul.
Article
em En
| MEDLINE
| ID: mdl-29771807
ABSTRACT
BACKGROUND:
Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration.OBJECTIVE:
The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy.DESIGN:
This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS The study was conducted at a single surgical unit of a public university hospital. PATIENTS Patients scheduled for elective rectosigmoid resection were considered for study inclusion. INTERVENTION Patients in whom a diverting ileostomy was created were randomly assigned to the intervention group (n = 39), which received an oral isotonic glucose-sodium hydration solution for 40 days postdischarge and the control group (n = 41) which did not receive an intervention. The 2 groups were compared with a group of patients who underwent rectosigmoid resection without diverting ileostomy (n = 37). MAIN OUTCOMEMEASURES:
Serum electrolyte and renal function markers were assessed preoperatively and at 20 and 40 days postdischarge.RESULTS:
At 20 days postdischarge, the serum sodium of the control group appeared lower than the serum sodium of the intervention group and the nonileostomy group (p = 0.007). At the same time point, urea and creatinine levels of the control group were higher than the urea and creatinine levels of the other 2 groups (p = 0.01 and p = 0.02). At 40 days postdischarge, mean sodium and renal function markers improved in the control group, but sodium and creatinine continued to differ in comparison with the intervention and nonileostomy groups (p = 0.01 and p = 0.04). The readmission rate for fluid and electrolyte abnormalities was higher in the control group (24%) than in the other 2 groups, where no rehospitalization for such a reason was required (p = 0.001).LIMITATIONS:
The study was limited by its single-center design.CONCLUSION:
An oral isotonic drink postdischarge can have a prophylactic effect on patients with a newly formed ileostomy, preventing readmission for fluid and electrolyte abnormalities. See Video Abstract at http//links.lww.com/DCR/A603.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
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Complicações Pós-Operatórias
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Reto
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Colo Sigmoide
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Ileostomia
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Soluções para Reidratação
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Desidratação
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Hidratação
Tipo de estudo:
Clinical_trials
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article