Fluid Overload Clinical Trial
Official title:
Peroperative and Postoperative Effects of Goal Directed Fluid Therapy in Gynecological Staging Surgery
The first objective of this study is to compare the liberal fluid management (LFM) with PVI guided goal-directed fluid management (GDFM) in gynecologic oncologic cases in terms of controlled intraoperative fluid balance, blood lactate levels, hemodynamic parameters, and postoperative serum creatinine levels. 112 patients who are in ASA I-II-lll risk groups included in this prospective study.
Objectives: The first objective of the investigators's study was to compare the liberal fluid
management (LFM) 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.
The investigators's secondary purpose was to compare the effects of different fluid regimens
on the postoperative kidney injury and the duration of hospital stay.
Methods: The study included 112 American Society of Anesthesiologists (ASA) grade I ,ll and
lll patients, aged above 18 and undergoing elective gynecologic oncologic case . 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 cyristalloid/kolloid injection 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 LFM
group, a 250-ml bolus cyristalloid/ kolloid injection 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, urine output, need for blood transfusion
,lokositoz,fever,stay in icu and length of hospital stay were recorded.
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