{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:56:46Z","timestamp":1784239006075,"version":"3.55.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Perioper Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Diligent fluid management is an instrumental part of Enhanced Recovery After Surgery. However, the effect of a ward regimen to limit intravenous fluid administration on outcome remains unclear. We performed a meta-analysis investigating the effect of a restrictive versus a conventional fluid regimen on complications in patients after non-cardiac surgery in the postoperative period on the clinical ward.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Study design<\/jats:title>\n                <jats:p>We performed a systematic search in MEDLINE, Embase, Cochrane Library, and CINAHL databases, from the start of indexing until June 2022, with constraints for English language and adult human study participants. Data were combined using classic methods of meta-analyses and were expressed as weighted pooled risk ratio (RR) or odds ratio (OR) with 95% confidence interval (CI). Quality assessment and risk of bias analyses was performed according to PRISMA guidelines.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Seven records, three randomized controlled trials, and four non-randomized studies were included with a total of 883 patients. A restrictive fluid regimen was associated with a reduction in overall complication rate in the RCTs (RR 0.46, 95% CI 0.23 to 0.95; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.03; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200935%). This reduction in overall complication rate was not consistent in the non-randomized studies (RR 0.74, 95% CI 0.53 to 1.03; <jats:italic>P<\/jats:italic> 0.07; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200945%). No significant association was found for mortality using a restrictive fluid regimen (RCTs OR 0.51, 95% CI 0.05 to 4.90; <jats:italic>P<\/jats:italic>\u2009=\u20090.56; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%, non-randomized studies OR 0.30, 95% CI 0.06 to 1.46; <jats:italic>P<\/jats:italic>\u2009=\u20090.14; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%). A restrictive fluid regimen is significantly associated with a reduction in postoperative length of stay in the non-randomized studies (MD\u2009\u2212\u20091.81\u00a0days, 95% CI\u2009\u2212\u20093.27 to\u2009\u2212\u20090.35; <jats:italic>P<\/jats:italic>\u2009=\u20090.01; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%) but not in the RCTs (MD 0.60\u00a0days, 95% CI\u2009\u2212\u20090.75 to 1.95; <jats:italic>P<\/jats:italic>\u2009=\u20090.38). Risk of bias was moderate to high. Methodological quality was very low to moderate.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This meta-analysis suggests restrictive fluid therapy on the ward may be associated with an effect on postoperative complication rate. However, the quality of evidence was moderate to low, the sample size was small, and the data came from both RCTs and non-randomized studies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13741-023-00337-9","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T12:01:51Z","timestamp":1695297711000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Restrictive versus conventional ward fluid therapy in non-cardiac surgery patients and the effect on postoperative complications: a meta-analysis"],"prefix":"10.1186","volume":"12","author":[{"given":"Joachim J.","family":"Bosboom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije","family":"Wijnberge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart F.","family":"Geerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Kerstens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Mythen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P. 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Dis Colon Rectum. 2008;51(11):1633\u201340.","journal-title":"Dis Colon Rectum"}],"container-title":["Perioperative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-023-00337-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13741-023-00337-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-023-00337-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T22:10:54Z","timestamp":1700259054000},"score":1,"resource":{"primary":{"URL":"https:\/\/perioperativemedicinejournal.biomedcentral.com\/articles\/10.1186\/s13741-023-00337-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,21]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["337"],"URL":"https:\/\/doi.org\/10.1186\/s13741-023-00337-9","relation":{},"ISSN":["2047-0525"],"issn-type":[{"value":"2047-0525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,21]]},"assertion":[{"value":"1 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. Denise P. Veelo reported receipt of grants and consultancy fees from Edwards Lifesciences, and research grants from Philips and Hemologic. Dr. Markus W. Hollmann reported serving as executive section editor of pharmacology for <i>Anaesthesia & Analgesia<\/i> and as section editor of anaesthesiology for the <i>Journal of Clinical Medicine<\/i> and receipt of speakers fees from CSL Behring and Eurocept BV and consultancy fees from Eurocept BV. Dr. Michael G. Mythen is a paid consultant for Edwards Lifesciences and Deltex Medical. His University chair is sponsored by Smiths Medical Ltd. He has received honoraria for speaking or travel expenses from Baxter, BBraun, Fresenius Kabi, Hospira, and LidCo, and is a board member of the Bloomsbury Innovation Group. The other authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"52"}}