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
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...
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| Veröffentlicht in: | Diseases of the colon & rectum 2018-07, Vol.61 (7), p.840-846 |
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| container_title | Diseases of the colon & rectum |
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| creator | Migdanis, Athanasios Koukoulis, Georgios Mamaloudis, Ioannis Baloyiannis, Ioannis Migdanis, Ioannis Kanaki, Maria Malissiova, Eleni Tzovaras, Georgios |
| description | 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 OUTCOME MEASURES: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. |
| doi_str_mv | 10.1097/DCR.0000000000001082 |
| format | Article |
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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 OUTCOME MEASURES: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.</description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1097/DCR.0000000000001082</identifier><identifier>PMID: 29771807</identifier><language>eng</language><publisher>United States: The American Society of Colon and Rectal Surgeons</publisher><subject>Aged ; Colectomy - methods ; Colon, Sigmoid - surgery ; Dehydration - blood ; Dehydration - prevention & control ; Digestive System Surgical Procedures - methods ; Female ; Fluid Therapy - methods ; Humans ; Ileostomy - methods ; Male ; Middle Aged ; Patient Readmission - statistics & numerical data ; Postoperative Care - methods ; Postoperative Complications - blood ; Postoperative Complications - prevention & control ; Rectum - surgery ; Rehydration Solutions - therapeutic use ; Sodium - blood ; Water-Electrolyte Imbalance - blood ; Water-Electrolyte Imbalance - prevention & control</subject><ispartof>Diseases of the colon & rectum, 2018-07, Vol.61 (7), p.840-846</ispartof><rights>2018 The American Society of Colon and Rectal Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3562-4147f02e41b5303e1b0869aa22042b93e862a8c26c1acb18e3cbdcc70309f113</citedby><cites>FETCH-LOGICAL-c3562-4147f02e41b5303e1b0869aa22042b93e862a8c26c1acb18e3cbdcc70309f113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29771807$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Migdanis, Athanasios</creatorcontrib><creatorcontrib>Koukoulis, Georgios</creatorcontrib><creatorcontrib>Mamaloudis, Ioannis</creatorcontrib><creatorcontrib>Baloyiannis, Ioannis</creatorcontrib><creatorcontrib>Migdanis, Ioannis</creatorcontrib><creatorcontrib>Kanaki, Maria</creatorcontrib><creatorcontrib>Malissiova, Eleni</creatorcontrib><creatorcontrib>Tzovaras, Georgios</creatorcontrib><title>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</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description>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 OUTCOME MEASURES: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.</description><subject>Aged</subject><subject>Colectomy - methods</subject><subject>Colon, Sigmoid - surgery</subject><subject>Dehydration - blood</subject><subject>Dehydration - prevention & control</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Female</subject><subject>Fluid Therapy - methods</subject><subject>Humans</subject><subject>Ileostomy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications - blood</subject><subject>Postoperative Complications - prevention & control</subject><subject>Rectum - surgery</subject><subject>Rehydration Solutions - therapeutic use</subject><subject>Sodium - blood</subject><subject>Water-Electrolyte Imbalance - blood</subject><subject>Water-Electrolyte Imbalance - prevention & control</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctOHDEQtKIg2AB_EEU-5sAQ2zM7j9xWCwQkJNCyEseRx9PDOvGMN36Aho_Nt6T3kQjlEF_cKlVXdXcR8pGzc86q4svFfHHO3jzOSvGOTPg0ZQlLp-V7MkFQJGnB8iPywfvvG45gxSE5ElVR8JIVE_Jr1vZ60D44GbQdqO2oHOidk4Zej-0efLAmbot7B88wBE8vDajgrBkDIL-lVybqll6gTnSNHBT4LbyANm7qBUi08R41PNWog7pbnUcdVlRi4zO4oIcnemPA-mD7kc66AI7OrbEOvXCeh-iewI1fkX_vrF8jim1ndIFOttev0J4hfdiMZaClS6elOSEHnTQeTvf_MVleXS7n18nt3beb-ew2Uek0F0nGs6JjAjLe4PlS4A0r80pKIVgmmiqFMheyVCJXXKqGl5CqplWqYCmrOs7TY_J5J7t29mcEH2rcVoExcgAbfY0yPBd5LjKkZjuqwh28g65eO91LN9ac1Ztgawy2_jdYbPu0d4hND-3fpj9JIqHcEV6swcP5Hya-gKtXIE1Y_V_7N9ocs90</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Migdanis, Athanasios</creator><creator>Koukoulis, Georgios</creator><creator>Mamaloudis, Ioannis</creator><creator>Baloyiannis, Ioannis</creator><creator>Migdanis, Ioannis</creator><creator>Kanaki, Maria</creator><creator>Malissiova, Eleni</creator><creator>Tzovaras, Georgios</creator><general>The American Society of Colon and Rectal Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180701</creationdate><title>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</title><author>Migdanis, Athanasios ; Koukoulis, Georgios ; Mamaloudis, Ioannis ; Baloyiannis, Ioannis ; Migdanis, Ioannis ; Kanaki, Maria ; Malissiova, Eleni ; Tzovaras, Georgios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3562-4147f02e41b5303e1b0869aa22042b93e862a8c26c1acb18e3cbdcc70309f113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Colectomy - methods</topic><topic>Colon, Sigmoid - surgery</topic><topic>Dehydration - blood</topic><topic>Dehydration - prevention & control</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Female</topic><topic>Fluid Therapy - methods</topic><topic>Humans</topic><topic>Ileostomy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications - blood</topic><topic>Postoperative Complications - prevention & control</topic><topic>Rectum - surgery</topic><topic>Rehydration Solutions - therapeutic use</topic><topic>Sodium - blood</topic><topic>Water-Electrolyte Imbalance - blood</topic><topic>Water-Electrolyte Imbalance - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Migdanis, Athanasios</creatorcontrib><creatorcontrib>Koukoulis, Georgios</creatorcontrib><creatorcontrib>Mamaloudis, Ioannis</creatorcontrib><creatorcontrib>Baloyiannis, Ioannis</creatorcontrib><creatorcontrib>Migdanis, Ioannis</creatorcontrib><creatorcontrib>Kanaki, Maria</creatorcontrib><creatorcontrib>Malissiova, Eleni</creatorcontrib><creatorcontrib>Tzovaras, Georgios</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Migdanis, Athanasios</au><au>Koukoulis, Georgios</au><au>Mamaloudis, Ioannis</au><au>Baloyiannis, Ioannis</au><au>Migdanis, Ioannis</au><au>Kanaki, Maria</au><au>Malissiova, Eleni</au><au>Tzovaras, Georgios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>61</volume><issue>7</issue><spage>840</spage><epage>846</epage><pages>840-846</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><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 OUTCOME MEASURES: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.</abstract><cop>United States</cop><pub>The American Society of Colon and Rectal Surgeons</pub><pmid>29771807</pmid><doi>10.1097/DCR.0000000000001082</doi><tpages>7</tpages></addata></record> |
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| ispartof | Diseases of the colon & rectum, 2018-07, Vol.61 (7), p.840-846 |
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| source | MEDLINE; Journals@Ovid Ovid Autoload |
| subjects | Aged Colectomy - methods Colon, Sigmoid - surgery Dehydration - blood Dehydration - prevention & control Digestive System Surgical Procedures - methods Female Fluid Therapy - methods Humans Ileostomy - methods Male Middle Aged Patient Readmission - statistics & numerical data Postoperative Care - methods Postoperative Complications - blood Postoperative Complications - prevention & control Rectum - surgery Rehydration Solutions - therapeutic use Sodium - blood Water-Electrolyte Imbalance - blood Water-Electrolyte Imbalance - prevention & control |
| title | 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 |
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