Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: A randomized controlled trial

Davinder S. Ramsingh, Chirag Sanghvi, Joseph Gamboa, Maxime Cannesson, Richard Lee Applegate

Research output: Contribution to journalArticle

72 Scopus citations

Abstract

Intraoperative goal directed fluid therapy (GDT) guided by an arterial pressure-based cardiac output system has been reported to improve gastrointestinal (GI) recovery in high-risk patients. This study evaluates the impact of this approach on GI recovery in low to moderate risk patients undergoing major abdominal surgery. IRB approved randomized controlled trial in low to moderate risk adults scheduled for major surgery. Patients were randomized to standard (n = 20) or GDT (n = 18) groups, whose fluids were managed to maintain stroke volume variation (SVV) <12 %. The primary outcome measure was GI recovery. Additional measures included quality of recovery score. Continuous, non-normally distributed by Mann-Whitney test; ordinal and nominal by Chi square analysis. GDT patients had lower average intraoperative SVV. The GDT group had faster return of GI function (p = 0.004) and higher quality of recovery scores. In low to moderate risk patients undergoing major abdominal surgery, intraoperative GDT guided by SVV optimization was associated with faster restoration of GI recovery and higher quality of recovery scores. These results suggest that outcome benefits related to the use of an intraoperative goal directed fluid protocol guided by SVV are not limited to high-risk patients.

Original languageEnglish (US)
Pages (from-to)249-257
Number of pages9
JournalJournal of Clinical Monitoring and Computing
Volume27
Issue number3
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • Goal directed therapy
  • Intraoperative hemodynamic monitoring
  • Stroke volume optimization
  • Stroke volume variation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Critical Care and Intensive Care Medicine
  • Health Informatics

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