Effectiveness of dietary diabetes insipidus bundle on the severity of postoperative fluid imbalance in pituitary region tumours: A randomized controlled trial.

摘要: Aim To test the effectiveness of nurse-led dietary diabetes insipidus (DI) bundle on severity postoperative fluid imbalance in pituitary region tumours. Design Blinded randomized controlled trial. Methods Patients aged 18-65 operated for sellar-suprasellar tumours an Indian tertiary care centre were enrolled through total enumeration sampling and underwent randomization with allocation concealment during Sep 2018-Feb 2019. Pre-operative DI, ventilation, renal failure or decompensated mellitus excluded. intervention group received a DI (validated by three Delphi rounds) four components: intake only water thirst avoidance following-added salt, high-protein foods caffeinated drinks. Treating clinicians investigator assessing outcome blinded about enrolment. Urine output, serum sodium, vasopressin requirement hospital stay assessed as primary outcomes. The measures monitored daily till 6th day. Analyses performed 'intention-to-treat' basis, irrespective compliance. Independent t-test Chi-square used. Results Of initial 63 patients, 50 fulfilling criteria to two groups over six days yielding 150 patient-days per group. There no significant baseline differences between groups. mean urine output was significantly lower than control, both overall among endonasal adenomas [3000.09(462.7) vs. 4095.71(896.4)ml & 2987.14(419.5) 4064.73(1051)ml], greatest difference second Though hypernatraemia controls became most prominent 2-3 resolved week, it (12.7% 30.7% overall, 11.4% 29.4% adenomas). need analogues also (p Conclusion This is probably first ever report which seem flatten trend benefits polyuria, hypernatraemia, stay. Trial registration CTRI/2018/07/015127 ICMR. Impact has effectively reduced patients Its implementation simple easy carry out, especially resource-constrained institutions, where continuous monitoring repeated sodium estimation are difficult.