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Rev Esp Anestesiol Reanim. 2019 May;66(5):259-266. doi: 10.1016/j.redar.2019.01.007. Epub 2019 Mar 10.

Goal-directed fluid therapy on laparoscopic colorectal surgery within enhanced recovery after surgery program.

[Article in English, Spanish]

Author information

1
Departamento de Anestesiología, Reanimación y Terapéutica de Dolor, Hospital General Universitario de Elche, Camí de l'Almazara 11, CP 03203 Elche, Alicante, España. Electronic address: martarspr@gmail.com.
2
Departamento de Anestesiología, Reanimación y Terapéutica de Dolor, Hospital General Universitario de Elche, Camí de l'Almazara 11, CP 03203 Elche, Alicante, España.

Abstract

INTRODUCTION:

Enhanced recovery after surgery protocols (ERAS) are used in peri-operative care to reduce the stress response to surgical aggression. As fluid overload has been associated with increased morbidity and delayed hospital discharge, a major aspect of this is fluid management. Intra-operative goal-directed fluid protocols have been shown to reduce post-operative complications, particularly in high risk patients.?.

OBJECTIVE:

To compare 2fluid therapy models (zero-balance versus goal-directed fluid therapy) in patients who were scheduled for laparoscopic colorectal surgery within an ERAS program, recording the rate of complications such as surgical site infection, ileus, post-operative náusea and vomiting, and variability of the estimated glomerular filtration rate (eGFR).

MATERIALS AND METHODS:

An observational, retrospective study was conducted including adults who were scheduled for elective laparoscopic colorectal surgery within an ERAS program, and to investigate the postoperative complication rate.

RESULTS:

A total of 128 patients were included in this study; 43 (33.6%) in the zero-balance group and 85 (66.4%) in the goal-directed fluid therapy group. The total fluids administered was lower in the goal-directed fluid therapy group, as well as the incidence of post-operative complications (surgical site infection, anastomotic leak, ileus, and postoperative náusea and vomiting). No significant differences were found for length of stay, intra-operative urine output, and variability of the eGFR.?.

CONCLUSION:

The results of this study show that by using a goal-directed fluid therapy algorithm, the total amount of fluids administered can be reduced, as well as obtaining a lower incidence of post-operative complications.

KEYWORDS:

Cirugía colorrectal; Colorectal surgery; Fluid therapy; Fluidoterapia; Fluidoterapia guiada por objetivos; Goal-directed fluid therapy

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