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Table 2 Trials of “goal-directed fluid therapy” (GDT) in abdominal surgery versus “zero-balance fluid therapy” (restricted)

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 (restricted vs. GDT) Intraoperative fluid volume, mL (restricted vs. GDT) Postoperative fluid volume, mL (restricted vs. GDT) Effect of GDT
Brandstrup et al. [62] Elective laparoscopic or open colectomy 150/ASA I-III Observer blinded/ODM, CardioQ®/intraoperative Postop. complications Optimizing SV (<10 %) with HES 6 %, 130/0.4
(Voluven®)
2 h fasting for fluid
500 mL saline if no fluid in 6 h
Coll: 475 vs. 810
Cryst: 443 vs. 483
Totala: 1491 vs. 1876
Early oral intake in an enhanced recovery protocol.
Iv-fluid if oliguria, tachycardia or hypotension
→ Complications
→ LOS
Mortality: 1 (restricted) vs. 1 (GDT)
Zhang et al. [64] Elective open GI surgery 60 in three groups:
4 mL/kg/h RL + GDT-HES,
4 mL/kg/h RL + GDT-RL, and
4 mL/kg/h RL alone/ASA I-II
Observer blinded/Datex Ohmeda®/intraoperative LOS Optimizing PPV (<11 %) with Ringer’s lactate and HES 6 % Not given Total volume:
GDT-HES: 1742 vs.
GDT-RL: 2109 vs.
RL alone: 1260
1.5–2.0 mL/kg/h crystalloid for 3 days
Oral intake not mentioned.
↓ LOS in GDT-HES
↓ Time to flatus in GDT-HES
→ Complications between groups
Mortality: none
Srinivasa et al. [61] Elective laparoscopic or open colectomy 85/ASA I-III Observer blinded/ODM, CardioQ®/intraoperative Surgical recovery score (SRS) Optimizing cFT (<350 ms) and SV (<10 %) with Gelofusine 13 patients with bowel preparation: 1000 mL crystalloid Coll: 297 vs. 591
Totala: 1614 vs. 1994
Early oral intake in an enhanced recovery protocol.
IV fluid if oliguria, tachycardia, or hypotension
→ SRS
→ LOS
→ Complications
Mortality: none
Phan et al. [60] Elective colorectal surgery 100/ASA I-III Observer blinded/ODM, CardioQ®/intraoperative LOS Optimizing cFT (<360 ms) and SV (<10 %) with any colloid 400 mL PreOp® the day before and 2 h preop. Coll: 0 vs. 500
Cryst: 1400 vs. 1500
Totala: 1500 vs. 2190
Early oral intake in an enhanced recovery protocol → LOS
→ Complications
Mortality: 1 (restricted) vs. 0 (GDT)
  1. LOS length of hospital stay, ODM Oesophageal Doppler Monitoring, SV Stroke Volume, PPV Pulse Pressure Variation, cFT corrected Flow Time
  2. aTotal volume infused including colloid, crystalloid and blood products
  3. ↑significantly increased, ↓ significantly decreased, → no significant changes