Impact of Various Fluid Volumes on Mechanical Ventilation Time, Hospitalization Duration, and Hospitalization Cost in Postoperative Patients with Left Ventricular Diastolic Dysfunction Undergoing Non-Cardiac Surgery.

Objective: To describe the effects of various fluid strategies on mechanical ventilation time and other outcomes in patients with diastolic dysfunction undergoing non-cardiac surgery.

Methods: After evaluation, 192 Intensive Care patients met the inclusion criteria. Based on infusion volume and fluid balance, we categorized patients into quartiles using two grouping methodologies. The first quartiles for total infusion volume on day one of ICU admission after surgery were as follows: Q1 ≤ 2.02 mL/kg/h; Q2 > 2.02 to 2.69 mL/kg/h; Q3 > 2.69 to 3.86 mL/kg/h; Q4 > 3.86 mL/kg/h. The second quartiles for fluid balance divided by actual body weight multiplied by the corresponding number of hours were as follows: G1 ≤ -0.07 mL/kg/h; G2 > -0.07 to 0.56 mL/kg/h; G3 > 0.56 to 1.54 mL/kg/h; G4>1.54 mL/kg/h. The primary outcome was mechanical ventilation time. The research utilized both univariate and multivariate negative binomial regression models.

Results: The fourth group (Q4 and G4) had a significant impact on mechanical ventilation time(<0.05).There were also significant differences between Q4 or G4 and some other groups in terms of ICU time, ICU cost, total hospital time, and total hospital cost ( < 0.05).After negative binomial regression analysis,Q2 and Q4 were approximately 2.406 times (95% CI 1.153-5.017, = 0.019) and 3.532 times (95% CI 1.812-6.883, < 0.01) longer than Q1 respectively, when grouped by infusion volume, but there was no significant difference between G groups. And Q4 or G4 also differed significantly from other parameters of clinical outcomes ( < 0.05).

Conclusion: For patients admitted to the ICU following non-cardiac surgery with left ventricular diastolic dysfunction, the greater the fluid infusion or fluid balance, the greater the mechanical ventilation time, ICU or hospital time, and cost.