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.
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.
Authors: H G Wakeling; M R McFall; C S Jenkins; W G A Woods; W F A Miles; G R Barclay; S C Fleming Journal: Br J Anaesth Date: 2005-09-09 Impact factor: 9.166
Authors: José E de Aguilar-Nascimento; Breno N Diniz; Aracelle V do Carmo; Eryka A O Silveira; Raquel M Silva Journal: World J Surg Date: 2009-02-21 Impact factor: 3.352
Authors: D Lahner; B Kabon; C Marschalek; A Chiari; G Pestel; A Kaider; E Fleischmann; H Hetz Journal: Br J Anaesth Date: 2009-07-23 Impact factor: 9.166
Authors: Rupert Pearse; Deborah Dawson; Jayne Fawcett; Andrew Rhodes; R Michael Grounds; E David Bennett Journal: Crit Care Date: 2005-11-08 Impact factor: 9.097
Authors: Marcel R Lopes; Marcos A Oliveira; Vanessa Oliveira S Pereira; Ivaneide Paula B Lemos; Jose Otavio C Auler; Frédéric Michard Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Anna Wrzosek; Joanna Jakowicka-Wordliczek; Renata Zajaczkowska; Wojciech T Serednicki; Milosz Jankowski; Malgorzata M Bala; Mateusz J Swierz; Maciej Polak; Jerzy Wordliczek Journal: Cochrane Database Syst Rev Date: 2019-12-12
Authors: João M Silva; Amanda Maria Ribas Rosa de Oliveira; Fernando Augusto Mendes Nogueira; Pedro Monferrari Monteiro Vianna; Marcos Cruz Pereira Filho; Leandro Ferreira Dias; Vivian Paz Leão Maia; Cesar de Souza Neucamp; Cristina Prata Amendola; Maria José Carvalho Carmona; Luiz M Sá Malbouisson Journal: Crit Care Date: 2013-12-10 Impact factor: 9.097