GDFT on fluid management in patients undergoing laparoscopic colorectal resection with an ERAS program
WANG Xiang
ZHOU Ting
FANG Jia-kai
LIANG Qi-bo
XU Rui
ZHANG Hong-fei
XU Shi-yuan
LEI Hong-yi
Abstract：Objective To investigate the effect of goal -directed fluid therapy (GDFT) on fluid management in patients undergoing laparoscopic colorectal resection with an enhanced recovery after surgery (ERAS) program.Methods Thirty-two patients undergoing laparoscopic colorectal resection ,were received monitor with Vigileo .cardiac output. The hemodynamic parameters including cardiac index (CI),stroke volume(SV) and stroke volume variation(SVV) were used to guide fluid therapy.The variation of mean arterial pressure (MAP)、heart rate (HR)、CO、CI、SV and SVV at the different time points including after anesthesia induction (T1),beginning of surgery (T2),one hour after pneumoperitone-um (T3),five minutes after laparotomy (T4) and the end of the surgery(T5) were recorded.The total volume of fluid in-cluding crystalloid and colloid , blood loss, urine output, requirement for vasoactive agents during operation were recor-ded.Visual Analogue Scale , Ramsay Sedation Score, recovery and operation -related complications after operation were recorded.Results MAP at time points T2～T5 were higher than that at T1 time point(P＜0.05),CO at T2 and T3 were lower than that at T4 and T5 (P＜0.05),while SV at T3～T5 were higher(P＜0.05).HR、CI at T1、T3～T5 was higher than that at T2(P＜0.05).SVV at T1、T2、T4、T5 were lower than that at T3(P＜0.05),while CO、SV at T4 and T5 were higher(P＜0.05).56%of patients used vasoactive agents during the operations , bleeding volume(81.87±41.48)mL, urine volume(294.37±210.33)mL, total volume of fluid infused (1 129.68±227.04)mL;the length of hospital stay af-ter operation(4.6±2.17) d. Conclusion GDFT based on ERAS program applied to patients undergoing laparoscopic can significantly promote fluid management and postoperative rehabilitation .Noting the influence of the pneumoperitoneum and patients position on the parameters of GDFT during the operations .
Keywords：enhanced recovery after surgerygoal-directed fluid thearpystroke volume variationcardiac in-dexpneumoperitoneumtotal volume of fluid infusedvasoactive agents
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1279-1282 )