Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial
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 m...
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| Veröffentlicht in: | Journal of clinical monitoring and computing 2013-06, Vol.27 (3), p.249-257 |
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| creator | Ramsingh, Davinder S. Sanghvi, Chirag Gamboa, Joseph Cannesson, Maxime Applegate, Richard L. |
| description | 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) |
| doi_str_mv | 10.1007/s10877-012-9422-5 |
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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.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-012-9422-5</identifier><identifier>PMID: 23264068</identifier><identifier>CODEN: JCMCFG</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Abdomen - surgery ; Adult ; Aged ; Aged, 80 and over ; Anesthesiology ; Critical Care Medicine ; Female ; Fluid Therapy - methods ; Gastrointestinal Tract - physiopathology ; Health Sciences ; Humans ; Intensive ; Intraoperative Care - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative ; Original Research ; Prospective Studies ; Risk Factors ; Single-Blind Method ; Statistics for Life Sciences ; Stroke Volume</subject><ispartof>Journal of clinical monitoring and computing, 2013-06, Vol.27 (3), p.249-257</ispartof><rights>Springer Science+Business Media New York 2012</rights><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-b45ecbda58d34229133cda77dc1ca5561c0288ff302916cb4d20c5b8f05341703</citedby><cites>FETCH-LOGICAL-c438t-b45ecbda58d34229133cda77dc1ca5561c0288ff302916cb4d20c5b8f05341703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10877-012-9422-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10877-012-9422-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23264068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramsingh, Davinder S.</creatorcontrib><creatorcontrib>Sanghvi, Chirag</creatorcontrib><creatorcontrib>Gamboa, Joseph</creatorcontrib><creatorcontrib>Cannesson, Maxime</creatorcontrib><creatorcontrib>Applegate, Richard L.</creatorcontrib><title>Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>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.</description><subject>Abdomen - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Fluid Therapy - methods</subject><subject>Gastrointestinal Tract - physiopathology</subject><subject>Health Sciences</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intraoperative Care - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative</subject><subject>Original Research</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Single-Blind Method</subject><subject>Statistics for Life Sciences</subject><subject>Stroke Volume</subject><issn>1387-1307</issn><issn>1573-2614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kcFuFSEUhonR2Nr6AG4MiRs3Yw8wDFx3ptFq0qQbuyYMMPdSmWEEJub6FD6yTKcaY9IVJ-H7f3L4EHpF4B0BEBeZgBSiAUKbXUtpw5-gU8IFa2hH2qd1ZlI0hIE4QS9yvgOAnWTkOTqhjHYtdPIU_bpZiomjw36ctSk4DngfdcDWJ2eKs3gIi7e4HFzS8xHbJflpjw9-f8DJ529Y9zaOfqqJvKS9S0fsJxziD1wiHqOtqeI2ctbFu6nk91jjpKc19rP2mziVFEOoY0leh3P0bNAhu5cP5xm6_fTx6-Xn5vrm6svlh-vGtEyWpm-5M73VXFpWV98RxozVQlhDjOa8IwaolMPAoN51pm8tBcN7OQBnLRHAztDbrXdO8fviclGjz8aFoCcXl6wI45RK6GBF3_yH3sUl1Z3vqU5yDqSrFNkok2LOyQ1qTn7U6agIqFWX2nSpqkutuhSvmdcPzUs_Ovs38cdPBegG5Hn9eJf-efrR1t_6YaF9</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Ramsingh, Davinder S.</creator><creator>Sanghvi, Chirag</creator><creator>Gamboa, Joseph</creator><creator>Cannesson, Maxime</creator><creator>Applegate, Richard L.</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7SC</scope><scope>7SP</scope><scope>7U5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial</title><author>Ramsingh, Davinder S. ; Sanghvi, Chirag ; Gamboa, Joseph ; Cannesson, Maxime ; Applegate, Richard L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-b45ecbda58d34229133cda77dc1ca5561c0288ff302916cb4d20c5b8f05341703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdomen - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Fluid Therapy - methods</topic><topic>Gastrointestinal Tract - physiopathology</topic><topic>Health Sciences</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intraoperative Care - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative</topic><topic>Original Research</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Single-Blind Method</topic><topic>Statistics for Life Sciences</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramsingh, Davinder S.</creatorcontrib><creatorcontrib>Sanghvi, Chirag</creatorcontrib><creatorcontrib>Gamboa, Joseph</creatorcontrib><creatorcontrib>Cannesson, Maxime</creatorcontrib><creatorcontrib>Applegate, Richard L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical monitoring and computing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramsingh, Davinder S.</au><au>Sanghvi, Chirag</au><au>Gamboa, Joseph</au><au>Cannesson, Maxime</au><au>Applegate, Richard L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><addtitle>J Clin Monit Comput</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>27</volume><issue>3</issue><spage>249</spage><epage>257</epage><pages>249-257</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><coden>JCMCFG</coden><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.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>23264068</pmid><doi>10.1007/s10877-012-9422-5</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdomen - surgery Adult Aged Aged, 80 and over Anesthesiology Critical Care Medicine Female Fluid Therapy - methods Gastrointestinal Tract - physiopathology Health Sciences Humans Intensive Intraoperative Care - methods Male Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative Original Research Prospective Studies Risk Factors Single-Blind Method Statistics for Life Sciences Stroke Volume |
| title | Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial |
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