Restrictive fluid management strategies and outcomes in liver transplantation: a systematic review
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REVIEW ARTICLE/BRIEF REVIEW
Restrictive fluid management strategies and outcomes in liver transplantation: a systematic review Strate´gies de prise en charge liquidienne restrictive et pronostics en transplantation he´patique : une revue syste´matique . Michae¨l Chasse´, MD PhD FRCPC . Franc¸ois Martin Carrier, MD MSc FRCPC Han Ting Wang, MD MSc FRCPC . Pierre Aslanian, MD FRCPC . Ste´fanie Iorio . Marc Bilodeau, MD FRCPC . Alexis F. Turgeon, MD MSc FRCPC Received: 15 March 2019 / Revised: 12 June 2019 / Accepted: 14 June 2019 Ó Canadian Anesthesiologists’ Society 2019
Abstract Purpose Restrictive fluid management strategies have been proposed to reduce complications in liver transplant recipients. We conducted a systematic review to evaluate the effects of restrictive perioperative fluid management strategies, compared with liberal ones, on postoperative outcomes in adult liver transplant recipients. Our primary outcome was acute kidney injury (AKI). Our secondary outcomes were bleeding, mortality, and other postoperative complications.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-019-01480-y) contains supplementary material, which is available to authorized users. F. M. Carrier, MD MSc FRCPC (&) Anesthesiology – Critical Care Medicine, Centre hospitalier de l’Universite´ de Montre´al (CHUM), Department of Anesthesiology and Pain Medicine, Universite´ de Montre´al, Centre de recherche du CHUM, 900, rue St-Denis, porte S03434, Montre´al, QC H2X 0A9, Canada e-mail: [email protected] M. Chasse´, MD PhD FRCPC Critical Care Medicine, Centre hospitalier de l’Universite´ de Montre´al (CHUM), Department of Medicine, Universite´ de Montre´al, Centre de recherche du CHUM, Montre´al, QC, Canada H. T. Wang, MD MSc FRCPC Critical Care Medicine, CIUSSS de l’Est-de-l’ıˆle-de-Montre´al Hoˆpital Maisonneuve-Rosemont, Department of Medicine, Universite´ de Montre´al, Montre´al, QC, Canada
Source We searched major databases (CINAHL, EMB Reviews, EMBASE, MEDLINE, and the grey literature) from their inception to 10 July 2018 for randomizedcontrolled trials (RCTs) and observational studies comparing two fluid management strategies (or observational studies reporting two outcomes with available data on fluid volume received) in adult liver transplant recipients. Study selection, data abstraction, and risk of bias assessment were performed by at least two investigators. Data from RCTs were pooled using risk ratios (RR) and mean differences (MD) with random-effect models. Principal findings We found seven RCTs and 29 observational studies. Based on RCTs, fluid management S. Iorio Universite´ de Sherbrooke, Sherbrooke, QC, Canada M. Bilodeau, MD FRCPC Liver Unit, Centre hospitalier de l’Universite´ de Montre´al (CHUM), Department of Medicine, Universite´ de Montre´al, Centre de recherche du CHUM, Montre´al, QC, Canada A. F. Turgeon, MD MSc FRCPC Anesthesiology – Critical Care Medicine, CHU de Que´bec – Universite´ Laval (Hoˆpital de l’Enfant-Je´sus), Department
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