From: Fluid therapy in the perioperative setting—a clinical review
Author | Surgery | No. of patients/ASA | Blinding/monitor/timing | Primary outcome | Intervention | Preoperative fluid volume, mL (control vs. GDT) | Intraoperative fluid volume, mL (control vs. GDT) | Postoperative fluid volume, mL (control vs. GDT) | Effect of GDT |
---|---|---|---|---|---|---|---|---|---|
Conway et al. [56] | Elective bowel surgery | 57/ASA I-III | No blinding/ODM (CardioQ®)/intraoperative | Cardiac output | Optimizing SV (<10 %) and cFT (<350 ms) with HES 6 % | Not given | Coll: 19 mL/kg vs.28 mL/kg Total: 55 mL/kg vs. 64 mL/kg | Not given | ↑ SV and CO → LOS → Complications ↓ Critical care admission Mortality: 1 (control) vs. 0 (GDT) |
Gan et al. [55] | Elective major urological or gynecological | 100/ASA I-III | No blinding/ODM (CardioQ®)/intraoperative | LOS | Optimizing cFT (<350 ms) and SV (<10 %) with HES 6 % | Not given | Coll: 282 vs. 847 Cryst: 4375 vs. 4405 Totala: 4775 vs. 5420 | Not given | ↓ LOS → Complications ↓ PONV Mortality not reported. |
Wakeling et al. [42]. 2005 | Elective colorectal resection | 128/ASA II (media) | Observer blinded/ODM (CardioQ®)/intraoperative | LOS | Optimizing SV (<10 %) with Haemaccel® or Gelofusine® | 1000–2000 Hartmann’s solution from midnight | Coll: 1500 vs. 2000 Cryst: 3000 vs. 3000 Total: not given | Not given Early oral intake | ↓ LOS ↓ Complications ↓ GI complications Mortality: d30: non; d60: 1 (control) vs. 0 (GDT) |
Noblett et al. [16] | Elective colorectal resection | 108/ASA II (median) | Observer blinded/ODM (CardioQ®)/intraoperative | LOS | Optimizing SV (<10 %) and cFT (<350 ms) with Volplex® | Not given | Coll: 1209 vs. 1340 Cryst: 2625 vs. 2298 Total: not given | Not given Early oral intake | ↓ LOS ↓ Complications ↓ Critical care admission ↓ Interleukin 6 response Mortality: 1 (control) vs. 0 (GDT) |
Lopes et al. [52] | Elective mixed GI and urological | 33/ASA II-IV | No blinding/IBPplus®/intraoperative | LOS | Optimizing PPV (≤10 %) with HES 6 % | Not given | Coll: 0 vs. 2247 Cryst: 1563 vs. 2176 Totala: 1694 vs. 4618 | Not given Patients transferred to ICU | ↓ LOS ↓ Complications ↓ Mechanical ventilation ↓ ICU stay Mortality: 5 (control) vs. 2 (GDT) |
Buettner et al. [57] | Elective general, urological, or gynecological | 80/ASA I-III | Not blinded. PiCCOplus®/intraoperative | ScvO2 and serum lactate | Optimizing SPV (<10 %) with HES 6 %, 130/0.4 (Voluven®) and vasopressors | Not given | Coll: 1000 vs. 1500 Cryst: 4250 vs. 4500 Total: not given | Not given | → ScvO2 or lactate → Complications → Mechanical ventilation → ICU stay Mortality: 1 (control) vs. 0 (GDT) |
Forget et al. [58] | Elective mixed GI surgery | 82/ASA II-III | Observer blinded/Masimo Set®/intraoperative | Whole blood lactate levels | Optimizing PVI (>13 %) with HES 6 %, 130/0.4 (Voluven®) and vasopressors | Not given | Coll: 1003 vs. 890 Cryst: 1815 vs. 1363 Totala: 2918 vs. 2394 | 48 h postop. Coll: 358 vs. 268 Cryst: 3516 vs. 3107 | ↓ Lactate levels → Complications → Renal function Mortality: 0 (control) vs. 2 (GDT) |
Mayer et al. [41] | Elective mixed GI surgery | 60/ASA III | Observer blinded/FloTrac®, Vigileo/intraoperative | LOS | Optimizing CI (≥2.5 L/min/m2) with crystalloids, colloids, inotropes and vasopressors | Not given | Coll: 817 vs. 1188 Cryst: 3153 vs. 2489 Totala: 4494 vs. 4528 | Not given | ↓ LOS ↓ Complications → Mechanical ventilation → ICU stay Mortality: 2 (control) vs. 2 (GDT) |
Benes et al. [54] | Elective mixed GI and vascular surgery | 120/ASA II-IV | Observer blinded/FloTrac®, Vigileo/intraoperative | Complications | Optimizing SVV (<10 %) with HES 6 %, 130/0.4 (Voluven®) and inotropes | Not given | Coll: 1000 vs. 1425 Cryst: 2459 vs. 2321 Totala: 3729 vs. 3746 | 8 h postop: Coll: 0 vs. 0 Cryst: 1528 vs. 1587 | ↓ Complications → ICU stay → LOS ↓ Lactate levels Mortality: 2 (control) vs. 1 (GDT) |
Challand et al. [59] | Elective open or laparoscopic colorectal surgery | 179 subdivided into: fit (123) vs. unfit (56)/ASA I-IV | Observer blinded/ODM (CardioQ®)/intraoperative | LOS | Optimizing SV (<10 %) with HES 6 %, 130/0.4 (Voluven®) | 971 vs. 1273 Hartmann’s solution | Coll: 336 vs. 1718 Cryst: 3593 vs. 3479 Totala: 4010 vs. 5309 | 1 postop. day: Fluid balance: 2011 vs. 2083 | Unfit patients: → LOS → Complications Fit patients: ↑ LOS ↑ ICU admission → Complications Mortality: d30: 2 (control) vs. 2 (GDT); d90: 4 (control) vs. 5 (GDT) |
Salzwedel et al. [53] | Elective general, urological, or gynecological | 160/ASA II-III | Patient blinded/ProAQT®, PULSION®/intraoperative | Complications | Optimizing PPV (<10 %) and CI (≥2.5 L/min/m2) with fluids, vasopressors and inotropes | Not given | Coll: 725 vs. 774 Cryst: 2680 vs. 2862 Total: not given | 24 h postop. Coll: 147 vs. 57 Cryst: 3452 vs. 3204 | ↓ Complications → LOS → Stay in postop. semi intensive care → Bowel movement Mortality: not given |
Pearse et al. [14] | Planned/urgent GI surgery | 734/ASA I-IV | No blinding/LiDCOrapid®/intraoperative and 6 h postop. | Complications and mortality d30 | Optimizing SV (<10 %) with any colloid and dopexamine | Not given | Coll: 500 vs. 1250 Cryst: 2000 vs. 1000 Totalb: 4024 vs. 4190 | Coll: 0 vs. 500 Cryst: 600 vs. 506 | → Mortality and complications d30 → Complications d7 → Mortality d30 Mortality: d30: 11 (control) vs. 12 (GDT); d180: 42 (control) vs. 28 (GDT) |