Analysis of goal-directed fluid therapy guided by stroke volume variation on the early recovery of gastrointestinal surgery: a Meta-analysis / 中国医师进修杂志

ABSTRACT

Objective To explore the influence of goal-directed fluid therapy guided by stroke volume variation (SVV) on the recovery of gastrointestinal function and the length of hospital stay in patients undergoing gastrointestinal surgery, thus provide evidence for clinical application. Methods The studies related to the functional recovery of patients undergoing gastrointestinal surgery, including goal-directed fluid therapy guided by SVV were search in the PubMed, Medline, Google Scholar, Web of Science, CNKI, VIP and Wanfang data from 2008 to 2017. The experiment group was treated with goal-directed fluid therapy, and the control group was treated with open fluid therapy. The key indexes included first time of exhaust time, postoperative first defecation time, postoperative first feeding time, length of postoperative hospital stay or total length of hospital of stay. The Meta-analysis used RevMan 5.3 statistical software. Results A total of 13 randomized controlled trials containing 851 patients was included. The total length of hospitalization was compared in 8 articles, and the results showed that the difference was statistically significant ( MD = -4.12, 95% CI-5.93 to-2.30, P < 0.01). The length of postoperative hospital stay was compared in 6 articles, and the results showed that the difference was statistically significant ( MD=-2.64, 95% CI-3.84 to-1.43, P<0.01). The first time of exhaust time was compared in 12 articles, and the results showed that the difference was statistically significant ( MD=-15.32, 95% CI-19.96 to-10.69, P<0.01). The postoperative first defecation time was compared in 7 articles, and the results showed that the difference was statistically significant ( MD=-13.55, 95% CI-17.86 to -9.24, P < 0.01). The postoperative first feeding time was compared in 7 articles, and the results showed that the difference was statistically significant ( MD=-13.20, 95% CI-17.61 to-8.80, P < 0.01). Conclusions Goal-directed fluid therapy by SVV programs can help patients undergoing gastrointestinal surgery with earlier recovery in gastrointestinal function and shorter length of hospital stay or postoperative hospital stay.