Goal directed fluid therapy for major liver resection: A multicentre randomized controlled trial

Annals of Medicine and Surgery
Laurence WeinbergChris Christophi

Abstract

The effect a restrictive goal directed therapy (GDT) fluid protocol combined with an enhanced recovery after surgery (ERAS) programme on hospital stay for patients undergoing major liver resection is unknown. We conducted a multicentre randomized controlled pilot trial evaluating whether a patient-specific, surgery-specific intraoperative restrictive fluid optimization algorithm would improve duration of hospital stay and reduce perioperative fluid related complications. Forty-eight participants were enrolled. The median (IQR) length of hospital stay was 7.0 days (7.0:8.0) days in the restrictive fluid optimization algorithm group (Restrict group) vs. 8.0 days (6.0:10.0) in the conventional care group (Conventional group) (Incidence rate ratio 0.85; 95% Confidence Interval 0.71:1.1; p = 0.17). No statistically significant difference in expected number of complications per patient between groups was identified (IRR 0.85; 95%CI: 0.45-1.60; p = 0.60). Patients in the Restrict group had lower intraoperative fluid balances: 808 mL (571:1565) vs. 1345 mL (900:1983) (p = 0.04) and received a lower volume of fluid per kg/hour intraoperatively: 4.3 mL/kg/hr (2.6:5.8) vs. 6.0 mL/kg/hr (4.2:7.6); p = 0.03. No significant differences in th...Continue Reading

References

Jun 5, 2007·Journal of the American College of Surgeons·Sophia ViraniKenneth K Tanabe
Jul 12, 2008·The British Journal of Surgery·R M van DamUNKNOWN Enhanced Recovery After Surgery (ERAS) Group
Mar 26, 2010·Annals of Internal Medicine·Kenneth F SchulzUNKNOWN CONSORT Group
May 29, 2010·Archives of Gynecology and Obstetrics·Hanan M F Al KadriHani M Tamim
Jun 18, 2010·Critical Care : the Official Journal of the Critical Care Forum·Jan BenesMartin Stepan
Dec 25, 2012·Journal of Clinical Monitoring and Computing·Davinder S RamsinghRichard L Applegate
Oct 24, 2013·Annals of Surgical Oncology·Erik M Dunki-JacobsRobert C G Martin
Mar 26, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Michael J HughesStephen J Wigmore
Jul 6, 2014·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Ke PengFu-hai Ji
Dec 4, 2014·Asian Journal of Endoscopic Surgery·Kazuhiko KitaguchiRyuichi Hayashi
Aug 21, 2015·World Journal of Gastroenterology : WJG·Tian-Gen NiBo Li
Sep 4, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jaap Jan VosAlain F Kalmar
May 11, 2018·The New England Journal of Medicine·Paul S MylesUNKNOWN Australian and New Zealand College of Anaesthetists Clinical Trials Network and the Australian and New Zealand Intensive Car

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Citations

May 19, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Iris M JongeriusDenise P Veelo
Jun 5, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Yasmin Abdelsalam KamelKhaled Ahmed Yassen

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