Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysis
Background Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between p...
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| description | Background Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received preoperative intravenous rehydration and those without for resection of PPGLs. Methods In this retrospective propensity score-matched cohort study, the data of patients who underwent surgery for PPGLs were collected. Patients were divided into two groups depending on whether they received or did not receive intravenous rehydration preoperatively. The primary endpoint was intraoperative hypotension, described as the cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration. Results Among 231 enrolled patients, 113 patients received intravenous rehydration of >= 2000 ml daily for >= 2 days before surgery and 118 patients who did not have any intravenous rehydration before surgery. After propensity score matching, 85 patients remained in each group. The median cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration was not significantly different between rehydrated patients and non-rehydrated patients (median 3.0% [interquartile range 0.2-12.2] versus 3.8% [0.0-14.2], median difference 0.0, 95%CI - 1.2 to 0.8, p = 0.909). The total dose of catecholamines given intraoperatively, volume of intraoperative fluids, intraoperative tachycardia and hypertension, percentage of patients who suffered from postoperative hypotension, postoperative diuretics use, and postoperative early outcome between the two groups were not significantly different either. Conclusions For patients with PPGLs, preoperative intravenous rehydration failed to optimize perioperative hemodynamics or improve early outcome. |
| doi_str_mv | 10.1186/s12871-020-01212-6 |
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A propensity score matching analysis</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SpringerNature Journals</source><source>PubMed Central Open Access</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Springer Nature OA/Free Journals</source><creator>Kong, Hao ; Yang, Jiao-Nan ; Tian, Jie ; Li, Nan ; Zhang, Yu-Xiu ; Ye, Peng-Cheng ; Li, Xue-Ying ; Zhang, Zheng</creator><creatorcontrib>Kong, Hao ; Yang, Jiao-Nan ; Tian, Jie ; Li, Nan ; Zhang, Yu-Xiu ; Ye, Peng-Cheng ; Li, Xue-Ying ; Zhang, Zheng</creatorcontrib><description>Background Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received preoperative intravenous rehydration and those without for resection of PPGLs. Methods In this retrospective propensity score-matched cohort study, the data of patients who underwent surgery for PPGLs were collected. Patients were divided into two groups depending on whether they received or did not receive intravenous rehydration preoperatively. The primary endpoint was intraoperative hypotension, described as the cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration. Results Among 231 enrolled patients, 113 patients received intravenous rehydration of >= 2000 ml daily for >= 2 days before surgery and 118 patients who did not have any intravenous rehydration before surgery. After propensity score matching, 85 patients remained in each group. The median cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration was not significantly different between rehydrated patients and non-rehydrated patients (median 3.0% [interquartile range 0.2-12.2] versus 3.8% [0.0-14.2], median difference 0.0, 95%CI - 1.2 to 0.8, p = 0.909). The total dose of catecholamines given intraoperatively, volume of intraoperative fluids, intraoperative tachycardia and hypertension, percentage of patients who suffered from postoperative hypotension, postoperative diuretics use, and postoperative early outcome between the two groups were not significantly different either. Conclusions For patients with PPGLs, preoperative intravenous rehydration failed to optimize perioperative hemodynamics or improve early outcome.</description><identifier>ISSN: 1471-2253</identifier><identifier>EISSN: 1471-2253</identifier><identifier>DOI: 10.1186/s12871-020-01212-6</identifier><identifier>PMID: 33250060</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>Anesthesia ; Anesthesiology ; Blood pressure ; Cardiac arrhythmia ; Care and treatment ; Catecholamines ; Catheters ; Comorbidity ; Diuretics ; Dopamine ; Drug dosages ; Esmolol ; Fluids ; Heart rate ; Hemodynamic instability ; Hemodynamics ; Hospitals ; Hypertension ; Hypotension ; Intravenous administration ; Intravenous rehydration ; Laparoscopy ; Life Sciences & Biomedicine ; Medical centers ; Medical research ; Medicine, Experimental ; Mortality ; Neuroendocrine tumors ; Orthostatic hypotension ; Outcome ; Paraganglioma ; Patients ; Pheochromocytoma ; Rehydration ; Science & Technology ; Software ; Standard deviation ; Surgeons ; Surgery ; Tachycardia ; Tumors</subject><ispartof>BMC anesthesiology, 2020-11, Vol.20 (1), p.294-10, Article 294</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>6</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000594936300001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c563t-b2288697d4116f536941d751e7dd7db566a8446b2ad37cf15ddeadbbede886f73</citedby><cites>FETCH-LOGICAL-c563t-b2288697d4116f536941d751e7dd7db566a8446b2ad37cf15ddeadbbede886f73</cites><orcidid>0000-0003-1661-654X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7702709/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7702709/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33250060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kong, Hao</creatorcontrib><creatorcontrib>Yang, Jiao-Nan</creatorcontrib><creatorcontrib>Tian, Jie</creatorcontrib><creatorcontrib>Li, Nan</creatorcontrib><creatorcontrib>Zhang, Yu-Xiu</creatorcontrib><creatorcontrib>Ye, Peng-Cheng</creatorcontrib><creatorcontrib>Li, Xue-Ying</creatorcontrib><creatorcontrib>Zhang, Zheng</creatorcontrib><title>Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysis</title><title>BMC anesthesiology</title><addtitle>BMC ANESTHESIOL</addtitle><addtitle>BMC Anesthesiol</addtitle><description>Background Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received preoperative intravenous rehydration and those without for resection of PPGLs. Methods In this retrospective propensity score-matched cohort study, the data of patients who underwent surgery for PPGLs were collected. Patients were divided into two groups depending on whether they received or did not receive intravenous rehydration preoperatively. The primary endpoint was intraoperative hypotension, described as the cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration. Results Among 231 enrolled patients, 113 patients received intravenous rehydration of >= 2000 ml daily for >= 2 days before surgery and 118 patients who did not have any intravenous rehydration before surgery. After propensity score matching, 85 patients remained in each group. The median cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration was not significantly different between rehydrated patients and non-rehydrated patients (median 3.0% [interquartile range 0.2-12.2] versus 3.8% [0.0-14.2], median difference 0.0, 95%CI - 1.2 to 0.8, p = 0.909). The total dose of catecholamines given intraoperatively, volume of intraoperative fluids, intraoperative tachycardia and hypertension, percentage of patients who suffered from postoperative hypotension, postoperative diuretics use, and postoperative early outcome between the two groups were not significantly different either. Conclusions For patients with PPGLs, preoperative intravenous rehydration failed to optimize perioperative hemodynamics or improve early outcome.</description><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Blood pressure</subject><subject>Cardiac arrhythmia</subject><subject>Care and treatment</subject><subject>Catecholamines</subject><subject>Catheters</subject><subject>Comorbidity</subject><subject>Diuretics</subject><subject>Dopamine</subject><subject>Drug dosages</subject><subject>Esmolol</subject><subject>Fluids</subject><subject>Heart rate</subject><subject>Hemodynamic instability</subject><subject>Hemodynamics</subject><subject>Hospitals</subject><subject>Hypertension</subject><subject>Hypotension</subject><subject>Intravenous administration</subject><subject>Intravenous rehydration</subject><subject>Laparoscopy</subject><subject>Life Sciences & Biomedicine</subject><subject>Medical centers</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Neuroendocrine tumors</subject><subject>Orthostatic hypotension</subject><subject>Outcome</subject><subject>Paraganglioma</subject><subject>Patients</subject><subject>Pheochromocytoma</subject><subject>Rehydration</subject><subject>Science & Technology</subject><subject>Software</subject><subject>Standard deviation</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Tachycardia</subject><subject>Tumors</subject><issn>1471-2253</issn><issn>1471-2253</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNUk2P0zAUjBCIXRb-AAdkiSPq4uckdsIBVFV8rLQSHOBsOfZL4qqxi-121b_BL8Ztl7KVOCAf_DSeGb9nT1G8BHoN0PC3EVgjYEYZnVFgwGb8UXEJVYYYq8vHD-qL4lmMS0pBNLR8WlyUJasp5fSy-PUtoF9jUMlukViXgtqi85tIAo47s8e9I70PZJ1LdCmSO5tGsh7R6zH4yetd8pOKRDmTOUENyg0ru4feERuJTcShxhhV2H0gc7IO-ToXbdqRqH1AMqmkR-uGbKBWu2jj8-JJr1YRX9zvV8WPTx-_L77Mbr9-vlnMb2e65mWadYw1DW-FqQB4X5e8rcCIGlAYI0xXc66aquIdU6YUuofaGFSm69Bg1vWivCpujr7Gq6VcBzvlFqVXVh4AHwapQrJ6hbJD0SkBbQ8VVKyBrlGtBmYYq5rOKMhe749e6003odG4f8jVmen5ibOjHPxWCkGZoG02eH1vEPzPDcYkl34T8otEyfIvMipoyf-yBpW7sq732UxPNmo55zXlFbSw97r-Bysvg5PV3mFvM34mYEeBDj7GgP2pcaByHzV5jJrMUZOHqMl9L68ejnyS_MlWJjRHwh12vo86p0fjiUYprduqzUPlisLCpkPUFn7jUpa--X9p-RslgPNP</recordid><startdate>20201130</startdate><enddate>20201130</enddate><creator>Kong, Hao</creator><creator>Yang, Jiao-Nan</creator><creator>Tian, Jie</creator><creator>Li, Nan</creator><creator>Zhang, Yu-Xiu</creator><creator>Ye, Peng-Cheng</creator><creator>Li, Xue-Ying</creator><creator>Zhang, Zheng</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1661-654X</orcidid></search><sort><creationdate>20201130</creationdate><title>Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysis</title><author>Kong, Hao ; Yang, Jiao-Nan ; Tian, Jie ; Li, Nan ; Zhang, Yu-Xiu ; Ye, Peng-Cheng ; Li, Xue-Ying ; Zhang, Zheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-b2288697d4116f536941d751e7dd7db566a8446b2ad37cf15ddeadbbede886f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Blood pressure</topic><topic>Cardiac arrhythmia</topic><topic>Care and treatment</topic><topic>Catecholamines</topic><topic>Catheters</topic><topic>Comorbidity</topic><topic>Diuretics</topic><topic>Dopamine</topic><topic>Drug dosages</topic><topic>Esmolol</topic><topic>Fluids</topic><topic>Heart rate</topic><topic>Hemodynamic instability</topic><topic>Hemodynamics</topic><topic>Hospitals</topic><topic>Hypertension</topic><topic>Hypotension</topic><topic>Intravenous administration</topic><topic>Intravenous rehydration</topic><topic>Laparoscopy</topic><topic>Life Sciences & Biomedicine</topic><topic>Medical centers</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Neuroendocrine tumors</topic><topic>Orthostatic hypotension</topic><topic>Outcome</topic><topic>Paraganglioma</topic><topic>Patients</topic><topic>Pheochromocytoma</topic><topic>Rehydration</topic><topic>Science & Technology</topic><topic>Software</topic><topic>Standard deviation</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Tachycardia</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kong, Hao</creatorcontrib><creatorcontrib>Yang, Jiao-Nan</creatorcontrib><creatorcontrib>Tian, Jie</creatorcontrib><creatorcontrib>Li, Nan</creatorcontrib><creatorcontrib>Zhang, Yu-Xiu</creatorcontrib><creatorcontrib>Ye, Peng-Cheng</creatorcontrib><creatorcontrib>Li, Xue-Ying</creatorcontrib><creatorcontrib>Zhang, Zheng</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC anesthesiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kong, Hao</au><au>Yang, Jiao-Nan</au><au>Tian, Jie</au><au>Li, Nan</au><au>Zhang, Yu-Xiu</au><au>Ye, Peng-Cheng</au><au>Li, Xue-Ying</au><au>Zhang, Zheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysis</atitle><jtitle>BMC anesthesiology</jtitle><stitle>BMC ANESTHESIOL</stitle><addtitle>BMC Anesthesiol</addtitle><date>2020-11-30</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>294</spage><epage>10</epage><pages>294-10</pages><artnum>294</artnum><issn>1471-2253</issn><eissn>1471-2253</eissn><abstract>Background Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received preoperative intravenous rehydration and those without for resection of PPGLs. Methods In this retrospective propensity score-matched cohort study, the data of patients who underwent surgery for PPGLs were collected. Patients were divided into two groups depending on whether they received or did not receive intravenous rehydration preoperatively. The primary endpoint was intraoperative hypotension, described as the cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration. Results Among 231 enrolled patients, 113 patients received intravenous rehydration of >= 2000 ml daily for >= 2 days before surgery and 118 patients who did not have any intravenous rehydration before surgery. After propensity score matching, 85 patients remained in each group. The median cumulative time of mean arterial pressure < 65 mmHg averaged by surgery duration was not significantly different between rehydrated patients and non-rehydrated patients (median 3.0% [interquartile range 0.2-12.2] versus 3.8% [0.0-14.2], median difference 0.0, 95%CI - 1.2 to 0.8, p = 0.909). The total dose of catecholamines given intraoperatively, volume of intraoperative fluids, intraoperative tachycardia and hypertension, percentage of patients who suffered from postoperative hypotension, postoperative diuretics use, and postoperative early outcome between the two groups were not significantly different either. Conclusions For patients with PPGLs, preoperative intravenous rehydration failed to optimize perioperative hemodynamics or improve early outcome.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>33250060</pmid><doi>10.1186/s12871-020-01212-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1661-654X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia Anesthesiology Blood pressure Cardiac arrhythmia Care and treatment Catecholamines Catheters Comorbidity Diuretics Dopamine Drug dosages Esmolol Fluids Heart rate Hemodynamic instability Hemodynamics Hospitals Hypertension Hypotension Intravenous administration Intravenous rehydration Laparoscopy Life Sciences & Biomedicine Medical centers Medical research Medicine, Experimental Mortality Neuroendocrine tumors Orthostatic hypotension Outcome Paraganglioma Patients Pheochromocytoma Rehydration Science & Technology Software Standard deviation Surgeons Surgery Tachycardia Tumors |
| title | Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas: is it necessary? A propensity score matching analysis |
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