Administration of an Oral Hydration Solution Prevents Electrolyte and Fluid Disturbances and Reduces Readmissions in Patients With a Diverting Ileostomy After Colorectal Surgery: A Prospective, Randomized, Controlled Trial. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Migdanis, Athanasios; Koukoulis, Georgios; Mamaloudis, Ioannis; Baloyiannis, Ioannis; Migdanis, Ioannis; Kanaki, Maria; Malissiova, Eleni; Tzovaras, Georgios
• Is Part Of: Diseases of the colon & rectum. Volume 61:Issue 7(2018)
• Publication Date: 2018-07
• Subjects: Dehydration -- Electrolyte profile -- Ileostomy -- Oral hydration -- Randomized clinical trial -- Readmission rate; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; Colonic Diseases -- Periodicals; Colorectal Surgery -- Periodicals; 616.34
• DOI: 10.1097/DCR.0000000000001082
• Languages: English
• ISSNs: 0012-3706

Abstract

Abstract : BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital. PATIENTS: Patients scheduled for elective rectosigmoid resection were considered for study inclusion. INTERVENTION: Patients in whom a diverting ileostomy was created were randomly assigned to the intervention group (n = 39), which received an oral isotonic glucose-sodium hydration solution for 40 days postdischarge and the control group (n = 41) which did not receive an intervention. The 2 groups were compared with a group of patients who underwent rectosigmoid resection without diverting ileostomy (n = 37). MAIN OUTCOME MEASURES: Serum electrolyte and renal function markers were assessed preoperatively and at 20 and 40 days postdischarge. RESULTS: At 20 days postdischarge, the serum sodium of the control group appeared lower than the serum sodium of the intervention group and the nonileostomy group ( p = 0.007). At the same time point, urea and creatinine levels of the control group were higher than the urea and creatinine levels of the other 2 groups ( p = 0.01 and p = 0.02). At 40 days postdischarge, mean sodium and renal function markers improved in the control group, but sodium and creatinine continued to differ in comparison with the intervention and nonileostomy groups ( p = 0.01 and p = 0.04). The readmission rate for fluid and electrolyte abnormalities was higher in the control group (24%) than in the other 2 groups, where no rehospitalization for such a reason was required ( p = 0.001). LIMITATIONS: The study was limited by its single-center design. CONCLUSION: An oral isotonic drink postdischarge can have a prophylactic effect on patients with a newly formed ileostomy, preventing readmission for fluid and electrolyte abnormalities. SeeVideo Abstract athttp://links.lww.com/DCR/A603 .