Tags

Type your tag names separated by a space and hit enter

Goal-directed fluid therapy based on stroke volume variations improves fluid management and gastrointestinal perfusion in patients undergoing major orthopedic surgery.
Med Princ Pract. 2014; 23(5):413-20.MP

Abstract

OBJECTIVE

To evaluate the influence of stroke volume variation (SVV)-based goal-directed therapy (GDT) on splanchnic organ functions and postoperative complications in orthopedic patients.

SUBJECTS AND METHODS

Eighty patients scheduled for major orthopedic surgery under general anesthesia were randomly allocated to one of two equal groups to receive either intraoperative volume therapy guided by SVV (GDT) or standard fluid management (control). In the SVV group, patients received colloid boluses of 4 ml/kg to maintain an SVV <10% when in the supine position or an SVV <14% if prone. In the control group, fluids were given to maintain a mean arterial pressure >65 mm Hg, a heart rate <100 bpm, a central venous pressure of 8-14 mm Hg, and a urine output >0.5 ml/kg/h. Intraoperative organ perfusion, hemodynamic data, hospitalization, postoperative complications, and mortality were recorded.

RESULTS

The heart rate at the end of surgery was significantly lower (p < 0.05), there were fewer hypotensive episodes (p < 0.05), the arterial and gastric intramucosal pH were higher (p < 0.05 for both), the gastric intramucosal PCO2 was lower (p < 0.05), the intraoperative infused colloids and the total infused volume were lower (p < 0.05 for both), and the postoperative time to flatus was shorter (p < 0.05) in the GDT group than in the control group. No differences in the length of hospital stay, complications, or mortality were found between the groups.

CONCLUSION

SVV-based GDT during major orthopedic surgery reduced the volume of the required intraoperative infused fluids, maintained intraoperative hemodynamic stability, and improved the perioperative gastrointestinal function.

Authors+Show Affiliations

Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24994571

Citation

Peng, Ke, et al. "Goal-directed Fluid Therapy Based On Stroke Volume Variations Improves Fluid Management and Gastrointestinal Perfusion in Patients Undergoing Major Orthopedic Surgery." Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre, vol. 23, no. 5, 2014, pp. 413-20.
Peng K, Li J, Cheng H, et al. Goal-directed fluid therapy based on stroke volume variations improves fluid management and gastrointestinal perfusion in patients undergoing major orthopedic surgery. Med Princ Pract. 2014;23(5):413-20.
Peng, K., Li, J., Cheng, H., & Ji, F. H. (2014). Goal-directed fluid therapy based on stroke volume variations improves fluid management and gastrointestinal perfusion in patients undergoing major orthopedic surgery. Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre, 23(5), 413-20. https://doi.org/10.1159/000363573
Peng K, et al. Goal-directed Fluid Therapy Based On Stroke Volume Variations Improves Fluid Management and Gastrointestinal Perfusion in Patients Undergoing Major Orthopedic Surgery. Med Princ Pract. 2014;23(5):413-20. PubMed PMID: 24994571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Goal-directed fluid therapy based on stroke volume variations improves fluid management and gastrointestinal perfusion in patients undergoing major orthopedic surgery. AU - Peng,Ke, AU - Li,Jian, AU - Cheng,Hao, AU - Ji,Fu-hai, Y1 - 2014/07/03/ PY - 2014/02/06/received PY - 2014/05/14/accepted PY - 2014/7/5/entrez PY - 2014/7/6/pubmed PY - 2015/6/3/medline SP - 413 EP - 20 JF - Medical principles and practice : international journal of the Kuwait University, Health Science Centre JO - Med Princ Pract VL - 23 IS - 5 N2 - OBJECTIVE: To evaluate the influence of stroke volume variation (SVV)-based goal-directed therapy (GDT) on splanchnic organ functions and postoperative complications in orthopedic patients. SUBJECTS AND METHODS: Eighty patients scheduled for major orthopedic surgery under general anesthesia were randomly allocated to one of two equal groups to receive either intraoperative volume therapy guided by SVV (GDT) or standard fluid management (control). In the SVV group, patients received colloid boluses of 4 ml/kg to maintain an SVV <10% when in the supine position or an SVV <14% if prone. In the control group, fluids were given to maintain a mean arterial pressure >65 mm Hg, a heart rate <100 bpm, a central venous pressure of 8-14 mm Hg, and a urine output >0.5 ml/kg/h. Intraoperative organ perfusion, hemodynamic data, hospitalization, postoperative complications, and mortality were recorded. RESULTS: The heart rate at the end of surgery was significantly lower (p < 0.05), there were fewer hypotensive episodes (p < 0.05), the arterial and gastric intramucosal pH were higher (p < 0.05 for both), the gastric intramucosal PCO2 was lower (p < 0.05), the intraoperative infused colloids and the total infused volume were lower (p < 0.05 for both), and the postoperative time to flatus was shorter (p < 0.05) in the GDT group than in the control group. No differences in the length of hospital stay, complications, or mortality were found between the groups. CONCLUSION: SVV-based GDT during major orthopedic surgery reduced the volume of the required intraoperative infused fluids, maintained intraoperative hemodynamic stability, and improved the perioperative gastrointestinal function. SN - 1423-0151 UR - https://www.unboundmedicine.com/medline/citation/24994571/Goal_directed_fluid_therapy_based_on_stroke_volume_variations_improves_fluid_management_and_gastrointestinal_perfusion_in_patients_undergoing_major_orthopedic_surgery_ L2 - https://www.karger.com?DOI=10.1159/000363573 DB - PRIME DP - Unbound Medicine ER -