Goal-directed fluid therapy in gastrointestinal cancer surgery: A prospective randomized study

Akyol D., Cukurova Z., Tulubas E., Yildiz G. O., Sabaz M. S.

JOURNAL OF ACUTE DISEASE, vol.11, no.2, pp.52-58, 2022 (ESCI) identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 2
  • Publication Date: 2022
  • Doi Number: 10.4103/2221-6189.342661
  • Journal Name: JOURNAL OF ACUTE DISEASE
  • Journal Indexes: Emerging Sources Citation Index (ESCI)
  • Page Numbers: pp.52-58
  • Keywords: Goal-directed fluid therapy, Liberal fluid therapy, Stroke volume variation, Open gastrointestinal cancer surgery, MAJOR ABDOMINAL-SURGERY, CONTROLLED-TRIAL, HOSPITAL STAY, CLINICAL-TRIAL, STROKE VOLUME, MANAGEMENT, METAANALYSIS, COMPLICATIONS, OPTIMIZATION, MORBIDITY
  • Marmara University Affiliated: Yes

Abstract

Objective: To investigate the effects of perioperative goal-directed fluid therapy (GDFT) on intraoperative fluid balance, postoperative morbidity, and mortality. Methods: This is a prospective randomized study, and 90 patients who underwent elective open gastrointestinal cancer surgery between April 2017 and May 2018 were included. Patients were randomized into 2 groups that received liberal fluid therapy (the LFT group, n=45) and goal-directed fluid therapy (the GDFT group, n=45). Patients' Colorectal Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) physiological score, Charlson Comorbidity Index (CCI), perioperative vasopressor and inotrope use, postoperative AKIN classification, postoperative intensive care unit (ICU) hospitalization, hospital stay, and 30-day mortality were recorded. Results: The volume of crystalloid used perioperatively and the total volume of fluid were significantly lower in the GDFT group compared to the LFT group (P < 0.05). CR-POSSUM physiological score and CCI were significantly higher in the GDFT group (P < 0.05). Although perioperative vasopressor and inotrope use was significantly higher in the GDFT group (P < 0.05), postoperative acute kidney injury development was not affected. Postoperative mortality was determined to be similar in both groups (P > 0.05). Conclusion: Although GDFT was demonstrated to be a good alternative method to LFT in open gastrointestinal cancer surgery, and it can prevent perioperative fluid overload, and the postoperative results are comparable in the two groups.