Goal-Directed Fluid Therapy in Gastrointestinal Surgery in Older Coronary Heart Disease Patients: Randomized Trial

• Published in: World journal of surgery 2013-12, Vol.37 (12), p.2820-2829
• Main Authors: Zheng, Hong, Guo, Hai, Ye, Jian-rong, Chen, Lin, Ma, Hai-ping
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adverse Cardiac Event; Aged; Aged, 80 and over; Cardiac Surgery; Coronary Disease - complications; Elective Surgical Procedures; Female; Fluid Therapy; Fluid Therapy - methods; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - surgery; General Surgery; Humans; Length of Stay - statistics & numerical data; Male; Mean Arterial Pressure; Medicine; Medicine & Public Health; Perioperative Care - methods; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Pulse Pressure Variation; Recovery of Function; Single-Blind Method; Stroke Volume Variation; Surgery; Thoracic Surgery; Treatment Outcome; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-013-2203-6

Background Our aim was to determine whether substitution of goal-directed fluid therapy (GDT) (perioperative fluid administration) for traditional therapy to manage elderly patients with coronary heart disease scheduled for gastrointestinal (GI) surgery was advantageous. We determined if it would reduce cardiac complications and shorten time to recovery and discharge. Methods Altogether, 60 of these elderly patients were randomized into GDT ( n  = 30) and control ( n  = 30) groups. In the GDT group, fluid management was carried out under guidance of hemodynamic status indicators. Types and quantities of fluids administered, blood loss, intraoperative urine output, time of extubation, intensive care unit (ICU) stay, hospital stay, postoperative adverse cardiac events, and GI complications were recorded. Results Total fluids infused were 2,910 ± 645 ml (GDT group) and 3,640 ± 771 ml (control group) ( p