Impact of a goal directed fluid therapy algorithm on postoperative morbidity in patients undergoing open right hepatectomy: a single centre retrospective observational study

BMC Anesthesiology
Laurence WeinbergChris Christophi

Abstract

Right hepatectomy is a complex procedure that carries inherent risks of perioperative morbidity. To evaluate outcome differences between a low central venous pressure fluid intervention strategy and a goal directed fluid therapy (GDFT) cardiac output algorithm we performed a retrospective observational study. We hypothesized that a GDFT protocol would result in less intraoperative fluid administration, reduced complications and a shorter length of hospital stay. Patients undergoing hepatectomy using an established enhanced recovery after surgery (ERAS) programme between 2010 and 2017 were extracted from a prospectively managed electronic hospital database. Inclusion criteria included adult patients, undergoing open right (segments V-VIII) or extended right (segments IV-VIII) hepatectomy. amount of intraoperative fluid administration used between the two groups. type and amount of vasoactive medications used, the development of predefined postoperative complications, hospital length of stay, and 30-day mortality. Complications were defined by the European Perioperative Clinical Outcome definitions and graded according to Clavien-Dindo classification. The association between GDFT and the amount of fluid and vasoactive medication ...Continue Reading

References

Jul 12, 2008·The British Journal of Surgery·R M van DamUNKNOWN Enhanced Recovery After Surgery (ERAS) Group
Jun 18, 2010·Critical Care : the Official Journal of the Critical Care Forum·Jan BenesMartin Stepan
Oct 24, 2013·Annals of Surgical Oncology·Erik M Dunki-JacobsRobert C G Martin
Dec 7, 2013·World Journal of Gastroenterology : WJG·Shan JinTu Wuyun
Aug 22, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Michael J HughesStephen J Wigmore
Sep 4, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jaap Jan VosAlain F Kalmar
Feb 24, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Francesca RattiLuca Aldrighetti

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Citations

Aug 30, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Olga RozentalChristopher W Tam
Jul 1, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Sriniket RaghavanDurgatosh Pandey
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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Methods Mentioned

BETA
dissection

Software Mentioned

GDFT
PlasmaLyte
STATA
IC

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