Major Abdominal Surgery Clinical Trial
Official title:
Implementation of Computer-Assisted Intraoperative Goal-Directed Fluid Therapy in Major Abdominal Surgery: A Before and After Study
The aim of this study is to compare the implementation of computer-assisted goal directed fluid therapy (GDFT) to standard of care fluid therapy in major abdominal surgery.
Fluid therapy is one of the main tools used in anesthesiology to maintain adequate
hemodynamic stability. Goal-directed fluid therapy (GDFT) based on cardiac output and/or
dynamic parameters of fluid responsiveness (e.g. pulse pressure variation) has been shown to
decrease post-operative complications. The main inconvenience of protocol based therapy is
its technical complexity which requires considerable time, attention, and vigilance. GDFT
assisted by a closed-loop system, when compared to manual GDFT, is associated with a longer
preload independent state and could increase clinician adherence to protocol. To this day no
study has compared closed-loop assisted GDFT to standard of care.
Goal:
This study compares the results of the study entitled "Crystalloids or Colloids for Goal
directed Fluid Therapy With Closed-loop Assistance in Major Surgery" (NCT02312999) to a
standard of care group (started retrospectively before the first included patient of the
above study) where fluid therapy is based only on static variables (e.g. arterial pressure,
heart rate, central venous pressure (CVP), and urine output.) These groups consisted of the
same population undergoing the same types of surgery.
Hypothesis:
A protocolized approach using computer-assisted GDFT when compared to standard of care is
associated with less fluid administration and less blood transfusions.
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