A Randomized Trial of Goal Directed vs Standard Fluid Therapy in Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

The use of adequate fluid therapy during cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. The aim of the study was to assess whether the use of fluid therapy protocol combined with goal-directed therapy (GDT) is associated with a significant ch...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2015-04, Vol.19 (4), p.722-729
Main Authors: Colantonio, Luca, Claroni, Claudia, Fabrizi, Luana, Marcelli, Maria Elena, Sofra, Maria, Giannarelli, Diana, Garofalo, Alfredo, Forastiere, Ester
Format: Article
Language:English
Subjects:
Abdomen
Adult
Aged
Antineoplastic Agents - therapeutic use
Cancer therapies
Chemotherapy
Clinical Protocols
Crystalloid Solutions
Cytoreduction Surgical Procedures
Female
Fentanyl
Fluid Therapy
Gastroenterology
General anesthesia
Goals
Hemodynamics
Humans
Infusions, Parenteral
Isotonic Solutions
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Monitoring, Physiologic
Mortality
Original Article
Patients
Peritoneal Neoplasms - drug therapy
Peritoneal Neoplasms - pathology
Peritoneal Neoplasms - surgery
Surgery
Surgical anastomosis
Treatment Outcome
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Summary:The use of adequate fluid therapy during cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. The aim of the study was to assess whether the use of fluid therapy protocol combined with goal-directed therapy (GDT) is associated with a significant change in morbidity, length of hospital stay, and mortality compared to standard fluid therapy. Patients American Society of Anesthesiologists (ASA) II–III undergoing CRS and HIPEC were randomized into two groups. The GDT group ( N  = 38) received fluid therapy according to a protocol guided by monitored hemodynamic parameters. The control group ( N  = 42) received standard fluid therapy. We evaluated incidence of major complications, total length of hospital stay, total amount of fluids administered, and mortality rate. The incidence of major abdominal complications was 10.5 % in GDT group and 38.1 % in the control group ( P  = 0.005). The median duration of hospitalization was 19 days in GDT group and 29 days in the control group ( P  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-015-2743-1