Home Intravenous Fluid Infusion After Undergoing Radical Cystectomy: A Randomized Controlled Trial
Johns Hopkins University
Summary
Radical cystectomy is the standard of care for muscle invasive bladder cancer, however despite advances, it is still associated with high morbidity. Many complications may be driven by dehydration and it is unclear if a home intravenous fluid (IVF) infusion program post-operatively, which is an accepted standard practice, is beneficial. This study is a single institution randomized controlled trial where patients who choose to undergo radical cystectomy for bladder cancer will be randomized to an Enhanced Recovery After Surgery (ERAS) protocol with a home IVF program, consisting of 1 liter (L) of crystalloid fluid three times per week for four weeks, or ERAS protocol alone. The primary outcome will be 90-day hospital re-admissions, with secondary outcomes including 30 and 90 day complications.
Description
The standard of care for patients with muscle-invasive bladder cancer is to undergo a radical cystectomy (RC), bilateral pelvic lymph node dissection and urinary diversion, but this surgery is associated with substantial perioperative morbidity frequently exceeding 60% 90-day complication rates. ERAS protocols have been widely adopted to improve perioperative outcomes in RC. These multimodal pathways reduce length of stay, expedite bowel recovery, and decrease overall complication rates, but have not consistently reduced readmission rates. The most common causes of readmission include dehydrat…