Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/47927 |
Resumo: | 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. |
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Clinics |
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Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictivePulse Pressure VariationGoal-Directed Fluid TherapyRestrictive Fluid TherapyGastrointestinal SurgeryOBJECTIVE: 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.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/4792710.6061/clinics/2012(10)06Clinics; Vol. 67 No. 10 (2012); 1149-1155Clinics; v. 67 n. 10 (2012); 1149-1155Clinics; Vol. 67 Núm. 10 (2012); 1149-11551980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/47927/51667Zhang, JunQiao, HuiHe, ZhiyongWang, YunChe, XuehuaLiang, Weimininfo:eu-repo/semantics/openAccess2012-12-13T11:00:29Zoai:revistas.usp.br:article/47927Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-12-13T11:00:29Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
title |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
spellingShingle |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive Zhang, Jun Pulse Pressure Variation Goal-Directed Fluid Therapy Restrictive Fluid Therapy Gastrointestinal Surgery |
title_short |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
title_full |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
title_fullStr |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
title_full_unstemmed |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
title_sort |
Intraoperative fluid management in open gastrointestinal surgery: goal-directed versus restrictive |
author |
Zhang, Jun |
author_facet |
Zhang, Jun Qiao, Hui He, Zhiyong Wang, Yun Che, Xuehua Liang, Weimin |
author_role |
author |
author2 |
Qiao, Hui He, Zhiyong Wang, Yun Che, Xuehua Liang, Weimin |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Zhang, Jun Qiao, Hui He, Zhiyong Wang, Yun Che, Xuehua Liang, Weimin |
dc.subject.por.fl_str_mv |
Pulse Pressure Variation Goal-Directed Fluid Therapy Restrictive Fluid Therapy Gastrointestinal Surgery |
topic |
Pulse Pressure Variation Goal-Directed Fluid Therapy Restrictive Fluid Therapy Gastrointestinal Surgery |
description |
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. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/47927 10.6061/clinics/2012(10)06 |
url |
https://www.revistas.usp.br/clinics/article/view/47927 |
identifier_str_mv |
10.6061/clinics/2012(10)06 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/47927/51667 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 67 No. 10 (2012); 1149-1155 Clinics; v. 67 n. 10 (2012); 1149-1155 Clinics; Vol. 67 Núm. 10 (2012); 1149-1155 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222759161167872 |