Effect of perioperative goal-directed fluid therapy on clinical outcome in elective colorectal resection
10.3760/cma.j.issn.1671-0274.2015.07.010
- VernacularTitle:围手术期目标导向液体治疗对结直肠手术临床结局的影响
- Author:
Qiang LIN
1
,
2
;
Huodong ZHOU
;
Dafeng LI
;
Jinfeng YE
;
Jinfu HONG
;
Yemao HU
Author Information
1. 529500 广东省阳江市人民医院肛肠外科
2. 529500 广东省阳江市人民医院麻醉科
- Keywords:
Colorectal resection;
Goal-directed fluid therapy;
Esophageal Doppler monitoring;
Clinical outcomes
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(7):671-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effect of perioperative goal-directed fluid therapy (GDFT) on clinical outcomes in elective colorectal resection. Methods A total of 42 patients undergoing elective colorectal resection between March 2013 and December 2014 were recruited prospectively. GDFT was administrated based on corrected left ventricular ejection time and stroke volume using the esophageal Doppler monitoring. These patients were compared with a historical cohort of 58 patients managed without GDFT from January 2012 to February 2013. The primary endpoint was postoperative hospital stay and complication rate. Results There was no significant difference in the overall fluid volumes administered intraoperatively between two groups [(2657±1037) ml vs. (2846±1444) ml, P>0.05], but patients in GDFT group received higher volume of colloid fluids [(935±556) ml vs. (688± 414) ml, P<0.05]. After a period of concordance at the start of operation, corrected left ventricular ejection time, stroke volume and cardiac index increased in GDFT group compared with control group (all P<0.05). No significant differences were found in postoperative hospital stay [(11.27±6.42) d vs. (12.04 ±7.18) d, P>0.05] and total complication rate (26.5% vs. 25.9%, P>0.05) between two groups, but GDFT group had earlier postoperative flatus [(3.52±0.84) d vs. (4.48±0.71) d, P<0.05] and faster tolerated diet [(5.92 ±1.18) d vs. (6.83 ±0.95) d, P<0.05]. Conclusions Patients undergoing elective colorectal resection do not benefit from intraoperative GDFT. Further studies should be carried out to investigate whether GDFT can be routinely used during colorectal resection.
