PractIce pattern of INtraoperative FlUid therapy in elective major gastrointeStinal cancer surgEries in India (I-INFUSE): A multicentre observational study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and Aims: Intraoperative fluid therapy is crucial in optimising outcomes after major abdominal surgeries. However, clinical practices vary widely due to uncertainty of appropriate choice of fluid, amount, rate and strategy of fluid administration, and factors like preoperative fluid deficits and intraoperative losses in major abdominal surgeries. Methods: Institutional ethics committee approvals were taken, and this multicentric study was registered with the Clinical Trials Registry-India. In the 3-month observation period, 810 patients undergoing major gastrointestinal (GI) cancer surgery across 30 centres in India were included. Data collected included patient demographics, surgical and anaesthetic details, types and volumes of fluids administered intraoperatively, haemodynamic monitoring, blood loss, transfusions, postoperative complications measured by Clavien–Dindo (CD) classification and Comprehensive Complication Index (CCI), and 30-day readmission. Along with the descriptive statistics, multivariate regression analyses were done to identify predictors outcomes with significance set at P < 0.05. Results: The mean intraoperative fluid administration was 5.34 {standard deviation(SD)}ml/kg/h, and the mean total volume administered was 2648.5 (SD: 1486.6) mL. Postoperative complication rates graded CD ≥3 were observed in 7.9% of patients. Multivariate analysis revealed that lower preoperative serum albumin, higher fluid administration rates, greater blood loss, and intraoperative blood transfusions were independently associated with increased postoperative morbidity and higher CCI scores. Minimally invasive surgery correlated with shorter hospital stays. Conclusion: Fluid therapy practices in major GI cancer surgeries and the mean fluid administration rate of 5.34 (SD: 2.51) mL/kg/h in the intraoperative period at Indian cancer centres align largely with recent international consensus guidelines.
Source: Indian Journal of Anaesthesia
Authors: Sohan Lal Solanki, Reshma Ambulkar, Virinchi Sanapala, Kalpana Balakrishnan, Rishikesh S. Bhatti, Deepa Chakrabarti, Jyotsna Goswami, Indira Gurajala, Hemlata Hemlata, Anuja Jain, Sofia Jaswal, Anjum Khan Joad, Kamal Kajal, Jyotirmay Kirtania, Lakshmi Kumar, Tapas Mandal, Indubala Maurya, Nitasha Mishra, Kusuma Parikh, Anjali Pingle, Namrata Ranganath, Seshadri Ramkiran, Basanth Kumar Rayani, Sandeep Sahu, Priyanka Sethi, Shagun Bhatia Shah, Jyoti Sharma, Koilada Shiv Kumar, Praveen Talawar, Raj Tobin, Sanjay Upadhye, Jigeeshu V. Divatia
Institutions: Homi Bhabha National Institute, Tata Memorial Hospital, Advanced Centre for Treatment, Research and Education in Cancer, Cancer Institute (WIA), Chittaranjan National Cancer Institute, Tata Medical Center, Nizam's Institute of Medical Sciences, King George's Medical University, Post Graduate Institute of Medical Education and Research, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Sir H.N. Reliance Foundation Hospital and Research Centre, All India Institute of Medical Sciences Bhubaneswar, P. D. Hinduja Hospital and Medical Research Centre, Kidwai Memorial Institute of Oncology, HCG Cancer Hospital, HCG Cancer Centre, Healthcare Global Enterprises, Basavatarakam Indo American Cancer Hospital and Research Institute, Sanjay Gandhi Post Graduate Institute of Medical Sciences, All India Institute of Medical Sciences Jodhpur, Rajiv Gandhi Cancer Institute and Research Centre, All India Institute of Medical Sciences, All India Institute of Medical Sciences Rishikesh, Max Super Speciality Hospital, Lilavati Hospital & Research Centre
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130720581