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Wide excision of head and neck cancer with microsurgical free flap's reconstruction (FFR) results to a high cancer cure rate and a good functional recovery. However, this long complex procedure is accompanied with considerable complications. Excessive fluid administration during this type of surgery has been connected with poor results. There is growing evidence that goal-directed fluid management (GDFM) might improve the results in high-risk patients.
Hypothesis: Goal directed fluid management will reduce intraoperative fluid volume administered to patients undergoing head and neck reconstructive surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Goal directed fluid management | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Goal directed fluid management based on continuous monitoring of stroke volume | Other | Baseline SV measurement, repeated volume loading (VL) with aliquots of 250 ml HES until SV increased < 10% in response to receding VL: SV is optimized, no further VL required. |
| Measure | Description | Time Frame |
|---|---|---|
| The volume of fluid administered intraoperatively during reconstructive surgery for head and neck oncology | Initiation of surgery to end of surgery on average 8-10 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of major complication and LOS | Cardiovascular, respiratory, neurologic, thromboembolic, renal,liver, GI, sepsis,and surgical complications willl be recorded | Post operative day 0 to hospital discharge |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Leonid Minkovich, MD | Toronto General Hospital, UHN | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Toronto General Hospital, UHN | Toronto | Ontario | M5G 2C4 | Canada |
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D009369 | Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
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