Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive
Clinics
;
67(10): 1149-1155, Oct. 2012. ilus, tab
Article
Dans Anglais
| LILACS
| ID: lil-653478
ABSTRACT
OBJECTIVE:
The optimal strategy for fluid management during gastrointestinal surgery remains unclear. Minimizing the variation in arterial pulse pressure, which is induced by mechanical ventilation, is a potential strategy to improve postoperative outcomes. We tested this hypothesis in a prospective, randomized study with lactated Ringer's solution and 6% hydroxyethyl starch solution.METHOD:
A total of 60 patients who were undergoing gastrointestinal surgery were randomized into a restrictive lactated Ringer's group (n = 20), a goal-directed lactated Ringer's group (n = 20) and a goal-directed hydroxyethyl starch group (n = 20). The goal-directed fluid treatment was guided by pulse pressure variation, which was recorded during surgery using a simple manual method with a Datex Ohmeda S/5 Monitor and minimized to 11% or less by volume loading with either lactated Ringer's solution or 6% hydroxyethyl starch solution (130/0.4). The postoperative flatus time, the length of hospital stay and the incidence of complications were recorded as endpoints.RESULTS:
The goal-directed lactated Ringer's group received the greatest amount of total operative fluid compared with the two other groups. The flatus time and the length of hospital stay in the goal-directed hydroxyethyl starch group were shorter than those in the goal-directed lactated Ringer's group and the restrictive lactated Ringer's group. No significant differences were found in the postoperative complications among the three groups.CONCLUSION:
Monitoring and minimizing pulse pressure variation by 6% hydroxyethyl starch solution (130/0.4) loading during gastrointestinal surgery improves postoperative outcomes and decreases the discharge time of patients who are graded American Society of Anesthesiologists physical status I/II.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Procédures de chirurgie digestive
/
Traitement par apport liquidien
Type d'étude:
Essai clinique contrôlé
/
Guide de pratique
Limites du sujet:
Adulte
/
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2012
Type:
Article
Pays d'affiliation:
Chine
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