GDFT for GI function following major abdominal surgery
Description
Goal-directed fluid therapy (GDFT) may improve gastrointestinal (GI) function after surgery. However, the evidence for beneficial effects of GDFT for recovery of GI function remains controversial. The aim of this study was to evaluate the effect of GDFT on recovery of GI function in patients undergoing major abdominal surgery. Materials and Methods In this randomized controlled trial, adult patients scheduled for elective major abdominal surgery with general anesthesia, were randomly divided into GDFT group and control group with standard routine care. In the GDFT group, intraoperative fluid infusion was administered according to stroke volume variation (SVV) and cardiac output index (CI) with the goal of maintaining SVV＜12% and CI≥2.5 L·min-1·m-2. POGD was evaluated by Intake, Feeling nauseated, Emesis, physical Exam, and Duration of symptoms (I-FEED) score system and defined as I-FEED score≥6. Time to the first flatus, time to first tolerate oral diet, and the length of hospital stay were also recorded. Results One hundred patients completed the study protocol. Two of 50 patients (4%) developed POGD in the GDFT group, whereas POGD occurred in 16 of 50 patients (32%) in the control group (P<0.0001). GDFT significantly shortened time to first flatus by 11 hours (P=0.009) and time to first tolerate oral diet by 2 days (P<0.0001). Moreover, the length of hospital stay was significantly shorter in GDFT group compared with the control group (12 days in GDFT group versus 15 days in control group, P=0.001). Conclusions GDFT guided by SVV and CI could accelerate the postoperative recovery of GI function and shorten length of hospital stay following major abdominal surgery.