RELIEF

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Myles PS, et al. "Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery". New England Journal of Medicine. 2018. 378(24):2263-2274.
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Clinical Question

In patients who had an increased risk of complication while undergoing major abdominal surgery, does a restrictive fluid regimen compared with a more traditional (liberal) fluid regimen reduce complications and improve disability-free survival?

Bottom Line

Restrictive fluid regimen was not associated with a higher rate of disability-free survival than a liberal fluid regimen 1 year after surgery,but was associated with a higher rate of acute kidney injury.

Major Points

Guidelines

  • Guidelines promoting early post operative recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery.

Design

Population

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Outcomes

Comparisons are NAME vs. NAME

Primary Outcomes

OUTCOME NAME
##% vs. ##% (HR ##; 95% CI ##-##; P=##)

Secondary Outcomes

Subgroup Analysis

Adverse Events

Criticisms

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Further Reading