Dissertation (MM General Surgery)
Background: Fluid resuscitation is an extremely important part of patients management in clinical settings. Different common surgical conditions e.g. excessive vomiting and acute severe hemorrhage, can lead to an increased fluid loss and disturb the patients physiological status leading to worse outcomes. Proper fluid administration to a surgical patient, can lead to patients improvement from their illness, and hence reducing morbidity and mortality which are the main problems. Therefore, this study was assessing Adequacy of Fluid Resuscitation and Outcomes of Emergency Surgical Patients, Attended at Iringa Regional Referral Hospital.
Methods: A hospital-based descriptive cross sectional study design of 162 emergency surgical patients was conducted at Iringa Regional Referral Hospital in Tanzania from February 2019 to April 2020
Results: Among the 162 study participants who were studied, majority 44 (27.2%) had intestinal obstruction while the least group had wet foot gangrene 2(1.2%). The rest were Peritonitis, Appendicitis/appendicular abscess, Chest injuries, Visceral injuries and multiple cut wounds (22.8%, 14.2%, 13.6%, 9.3%, 8.6%) respectively.
Fluid resuscitation caused changes in pulse rate (96.16 ± 14.295 vs. 86.70 ± 22.441), respiratory rate (21.02 ± 2.796 vs. 18.96 ± 2.796), SBP (101.81± 20.727 mmHg vs. 106.70 ± 22.441 mmHg) and DBP (62.54 ± 13.648 mmHg vs. 65.12 ± 18.152 mmHg), MAP (75.254 ± 15.459 mmHg vs. 78.778 ± 21.4426 mmHg) and temperature 37.10± 1.159 vs.35.756±7.068 as from the time of admission and 24 hours post resuscitation.
Conclusion: This study has shown a significant improvement of patients clinical conditions following fluid administration basing on vital signs, from time of admission up to 24hrs post resuscitation. Personalized fluid administration in patients requires clinicians to integrate abnormal physiological parameters into a clinical decision making. The physiological parameters include; vital signs, urine output and body weight recordings.