Analysis of the Impact of the Infusion Volume of Intraoperative Intravenous Solutions on the Length of Hospital Stay

Abstract

Introduction: The infusion of intraoperative intravenous solutions aims to optimize preload, oxygen transport, hemodynamic stability, and correct deficits in the patient’s clinical condition. However, the infused volume often diverges from the recommendations of protocols like Enhanced Recovery After Surgery (ERAS) and Aceleração da Recuperação Total Pós-Operatória (ACERTO) due to the subjectivity involved. Excessive fluid replacement is associated with renal hypoperfusion, tachyarrhythmia, and worsening respiratory patterns, with the risk of progression to sepsis and multiple organ failure. Objective: To assess the relationship between volume of intraoperative intravenous fluid infusion and length of hospital stay in individuals undergoing elective herniorrhaphy and laparoscopic cholecystectomy at a quaternary care hospital. Methods:  A retrospective cross-sectional study reviewed 400 medical records of patients who underwent surgeries between January 1 and December 31, 2022. The study evaluated postoperative hospital length of stay and the infused volume in patients without complications and without need for intensive care. Results: The median age was 57 years; 47% of patients were men and 54% women. Comorbidities such as hypertension and diabetes were present in 37.5% of cases, and 66% of patients were classified as ASA 2. The most common procedures were cholecystectomies (50%) and inguinal herniorrhaphies (26%). The predominant infusion was normal saline, with a median volume of 1,100 mL. About 80% of patients were discharged on the first postoperative day. Conclusion: There was no significant correlation between the infused volume and the length of hospital stay. Multicenter studies are needed to understand the effects of this intervention in medium-sized procedures.