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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