Fluid Overload Clinical Trial
Official title:
Comparison of PVI-guided Fluid Management With Traditional Fluid Management in Colorectal Surgery
The first objective of this study was to compare the traditional fluid management (TFM) with PVI guided goal-directed fluid management (GDFM) in terms of controlled intraoperative fluid volume, surgical end-point fluid balance, blood lactate and serum creatinine levels. ASA I-II 70 patients included in this prospective study.
Objectives: The first objective of our study was to compare the traditional fluid management
(TFM) with PVI guided goal-directed fluid management (GDFM) in terms of controlled
intraoperative fluid volume, surgical end-point fluid balance, blood lactate and serum
creatinine levels. Our secondary purpose was to compare the effects of different fluid
regimens on the return of bowel function and the duration of hospital stay. Methods: The
study included 70 American Society of Anesthesiologists (ASA) grade I and II patients, aged
above 18 and undergoing elective colorectal surgery. After premedication with 0.03 mg /kg
i.v. midazolam, all patients were started an i.v. infusion of 500 mL 0.9 % NaCl until the end
of anesthesia induction.
After the anesthesia induction, while 0.9 % NaCl at rate of 2 mL/kg/h was infused in PVI-
guided GDFM group, a 250-mL bolus gelatin injection (Gelofusine®, Barun) was administered
when PVI was higher than 13 % over 5 min. While 0.9 % NaCl at rate of 4- 8 mL/kg/h was
infused in TFM group, a 250-ml bolus gelatin injection (Gelofusine®, Barun) was administered
when the mean arterial blood pressure (MAP) decreased below 65 mmHg. In both groups, when MAP
was still < 65 mmHg after fluid bolus infusion, 5 mg i.v. bolus ephedrine was administered.
The data collected during intraoperative period, such as heart rate, MAP, arterial blood gas
samples (Ph, arterial oxygen pressure (PaO2), arterial carbon dioxide pressure (PaCO2), HCO3
level, hemoglobin, blood lactate level) were recorded. Hemoglobin, Na, K, Cl, serum
creatinine, blood lactate and serum albumin scores were measured preoperatively, and up to 24
hours postoperative.
In the first 24 hours after surgery, oliguria (<0.5 ml / kg urine output), need for blood
transfusion and the time of first bowel movement (depending on the days after surgery),
length of hospital stay were recorded.
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