Impact of the FloTrac/VigileoTM Monitoring on Intraoperative Fluid Management and Outcome after Liver Resection.
Dig Surg
; 35(5): 435-441, 2018.
Article
in En
| MEDLINE
| ID: mdl-29073613
ABSTRACT
BACKGROUNDS Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS:
We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs. patients who did not (group B). We searched for differences about hemodynamics, fluid therapy and outcome.RESULTS:
Three hundred fifty-five patients underwent hepatic resection due to neoplasm group A - n = 179 and group B - n = 176. At the end of the resection, patients of group A showed a higher mean arterial pressure (MAP) than group B (74 ± 12 vs. 49.4 ± 8 mm Hg, respectively; p < 0.001). Cardiac index and stroke volume variation in group A were within a normal range. Fluid input was higher in group B than in group A (12.0 ± 3.4 vs. 7.6 ± 3.1 mL/kg/h, respectively; p < 0.001) and fluid balance was significantly different group A -400 ± 1,527 vs. group B 326 ± 1,527 mL (p < 0.001). Group B showed a greater number of cases complicated outcomes (36 vs. 20; p = 0.014). Considering only those subjects who were able to reach their hemodynamic targets (MAP ≥65 mm Hg and CVP ≤7 mm Hg), we found similar data.CONCLUSIONS:
Patients who received a monitored fluid therapy experienced a safer outcome.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Monitoring, Intraoperative
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Fluid Therapy
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Hemodynamics
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Hepatectomy
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Intraoperative Care
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Liver Neoplasms
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Dig Surg
Journal subject:
GASTROENTEROLOGIA
Year:
2018
Document type:
Article
Affiliation country:
Italia