TY - JOUR
T1 - Bioelectrical impedance analysis in patients undergoing major head and neck surgery
T2 - A prospective observational pilot study
AU - Tzelnick, Sharon
AU - Singer, Pierre
AU - Shopen, Yoni
AU - Moshkovitz, Limor
AU - Fireman, Shlomo
AU - Shpitzer, Thomas
AU - Mizrachi, Aviram
AU - Bachar, Gideon
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background: Head and neck patients are prone to malnutrition. Perioperative fluids administration in this patient group may influence nutritional status. We aimed to investigate perioperative changes in patients undergoing major head and neck surgery and to examine the impact of perioperative fluid administration on body composition and metabolic changes using bioelectrical impedance. Furthermore, we sought to correlate these metabolic changes with postoperative complication rate. In this prospective observational pilot study, bioelectrical impedance analysis (BIA) was performed preoperatively and on postoperative days (POD) 2 and 10 on patients who underwent major head and neck surgeries. BIA was completed in 34/37 patients; mean total intraoperative and post-anesthesia fluid administration was 3682 ± 1910 mL and 1802 ± 1466 mL, respectively. Total perioperative fluid administration was associated with postoperative high extra-cellular water percentages (p = 0.038) and a low phase-angle score (p < 0.005), which indicates low nutritional status. Patients with phase angle below the 5th percentile at POD 2 had higher local complication rates (p = 0.035) and longer hospital length of stay (LOS) (p = 0.029). Multivariate analysis failed to demonstrate that high-volume fluid administration and phase angle are independent factors for postoperative complications. High-volume perioperative fluids administration impacts postoperative nutritional status with fluid shift toward the extra-cellular space and is associated with factors that increase the risk of postoperative complications and longer LOS. An adjusted, low-volume perioperative fluid regimen should be considered in patients with comorbidities in order to minimize postoperative morbidity.
AB - Background: Head and neck patients are prone to malnutrition. Perioperative fluids administration in this patient group may influence nutritional status. We aimed to investigate perioperative changes in patients undergoing major head and neck surgery and to examine the impact of perioperative fluid administration on body composition and metabolic changes using bioelectrical impedance. Furthermore, we sought to correlate these metabolic changes with postoperative complication rate. In this prospective observational pilot study, bioelectrical impedance analysis (BIA) was performed preoperatively and on postoperative days (POD) 2 and 10 on patients who underwent major head and neck surgeries. BIA was completed in 34/37 patients; mean total intraoperative and post-anesthesia fluid administration was 3682 ± 1910 mL and 1802 ± 1466 mL, respectively. Total perioperative fluid administration was associated with postoperative high extra-cellular water percentages (p = 0.038) and a low phase-angle score (p < 0.005), which indicates low nutritional status. Patients with phase angle below the 5th percentile at POD 2 had higher local complication rates (p = 0.035) and longer hospital length of stay (LOS) (p = 0.029). Multivariate analysis failed to demonstrate that high-volume fluid administration and phase angle are independent factors for postoperative complications. High-volume perioperative fluids administration impacts postoperative nutritional status with fluid shift toward the extra-cellular space and is associated with factors that increase the risk of postoperative complications and longer LOS. An adjusted, low-volume perioperative fluid regimen should be considered in patients with comorbidities in order to minimize postoperative morbidity.
KW - Bioelectrical impedance analysis
KW - Head and neck surgery
KW - Perioperative complications
UR - http://www.scopus.com/inward/record.url?scp=85112635952&partnerID=8YFLogxK
U2 - 10.3390/jcm10030539
DO - 10.3390/jcm10030539
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 33540593
AN - SCOPUS:85112635952
SN - 2077-0383
VL - 10
SP - 1
EP - 10
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 3
M1 - 539
ER -