Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicentre study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-04-05

AUTHORS

Thomas W. L. Scheeren, Christoph Wiesenack, Herwig Gerlach, Gernot Marx

ABSTRACT

Perioperative hemodynamic optimisation improves postoperative outcome for patients undergoing high-risk surgery (HRS). In this prospective randomized multicentre study we studied the effects of an individualized, goal-directed fluid management based on continuous stroke volume variation (SVV) and stroke volume (SV) monitoring on postoperative outcomes. 64 patients undergoing HRS were randomized either to a control group (CON, n = 32) or a goal-directed group (GDT, n = 32). In GDT, SVV and SV were continuously monitored (FloTrac/Vigileo) and patients were brought to and maintained on the plateau of the Frank-Starling curve (SVV <10 % and SV increase <10 % in response to fluid loading). Organ dysfunction was assessed using the SOFA score and resource utilization using the TISS score. Patients were followed up to 28 days for postoperative complications. Main outcome measures were the number of complications (infectious, cardiac, respiratory, renal, hematologic and abdominal post-operative complications), maximum SOFA score and cumulative TISS score during ICU stay, duration of mechanical ventilation, length of ICU stay, and time until fit for discharge. 12 patients had to be excluded from final analysis (6 in each group). During surgery, GDT received more colloids than CON (1,589 vs. 927 ml, P < 0.05) and SVV decreased in GDT (from 9.0 to 8.0 %, P < 0.05) but not in CON. The number of postoperative wound infections was lower in GDT (0 vs. 7, P < 0.01). Although not statistically significant, the proportion of patients with at least one complication (46 vs. 62 %), the number of postoperative complications per patient (0.65 vs. 1.40), the maximum sofa score (5.9 vs. 7.2), and the cumulative TISS score (69 vs. 83) tended to be lower. This multicentre study shows that fluid management based on a SVV and SV optimisation protocol is feasible and decreases postoperative wound infections. Our findings also suggest that a goal-directed strategy might decrease postoperative organ dysfunction. More... »

PAGES

225-233

References to SciGraph publications

  • 2010-04-08. Goal-directed therapy in high-risk surgical patients: a 15-year follow-up study in INTENSIVE CARE MEDICINE
  • 2005-11-22. Highs and lows in high-risk surgery: the controversy of goal-directed haemodynamic management in CRITICAL CARE
  • 2011-07-06. Epidemiology and outcome following post-surgical admission to critical care in INTENSIVE CARE MEDICINE
  • 2006-06-02. Identification and characterisation of the high-risk surgical population in the United Kingdom in CRITICAL CARE
  • 2000-10-13. Pathophysiology of fluid imbalance in CRITICAL CARE
  • 2011-06-24. Haemodynamic goal-directed therapy and postoperative infections: earlier is better. a systematic review and meta-analysis in CRITICAL CARE
  • 2008-06-04. A positive fluid balance is associated with a worse outcome in patients with acute renal failure in CRITICAL CARE
  • 1997-01. A cost analysis of a treatment policy of a deliberate perioperative increase in oxygen delivery in high risk surgical patients in INTENSIVE CARE MEDICINE
  • 2010-06-16. Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study in CRITICAL CARE
  • 2002-03-26. Pre-operative optimisation employing dopexamine or adrenaline for patients undergoing major elective surgery: a cost-effectiveness analysis in INTENSIVE CARE MEDICINE
  • 2011-06-15. Early non-invasive cardiac output monitoring in hemodynamically unstable intensive care patients: A multi-center randomized controlled trial in CRITICAL CARE
  • 2005-03-08. Pulse pressure variations to predict fluid responsiveness: influence of tidal volume in INTENSIVE CARE MEDICINE
  • 2009-10-26. Clinical review: Goal-directed therapy in high risk surgical patients in CRITICAL CARE
  • 1998-10. Relationship between TISS and ICU cost in INTENSIVE CARE MEDICINE
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s10877-013-9461-6

    DOI

    http://dx.doi.org/10.1007/s10877-013-9461-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1029107255

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23558909


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