In Reply

We would like to thank Drs. Slagt and van Eijk for their interesting comments regarding our recent publication.1 These authors suggested that the complexity of surgery, resulting in a longer procedure (1  h longer in the crystalloid group), and not the type of fluid was responsible for the higher incidence of postoperative complications in the crystalloid group, due to a higher inflammatory response. We have no data to support more complex surgeries in the crystalloid group beyond the surgical tim e because surgical procedures and incidences of high-risk surgery were comparable in the two groups. Additionally, blood loss was also not different between the two groups, further supporting similar surgical complexity among the two groups. If the inflammatory response related to the surgical proce dure was responsible for the higher fluid balance in the crystalloid group, we might also have expected a significantly higher fluid balance on postoperative day 1 in this group, which was not demonstrated. In order to take into account the difference in surgical duration, we originally presented ou r results in ml · kg–1· h–1 and observed a significantly higher fluid administration in the crystalloid group. It is true that we did not directly measure any parameter, which may have indicated a more severe inflammatory response in the crystalloid group than in the colloid group. As a result, we could not completely rule out the hypothesis of Drs. Slagt and van Eijk. To further inve...

Source: Anesthesiology - July 17, 2018 Category: Anesthesiology Source Type: research