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| Name | Class |
|---|---|
| Ministry of Science and Technology, Taiwan | OTHER_GOV |
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Anesthetic management and fluid therapy is crucial in esophageal resection and reconstruction, which is associated with high incidence of postoperative morbidity and mortality. This study aims to investigate the effect of goal directed fluid management on the postoperative outcome of esophageal resection and reconstruction.
Anesthetic management and fluid therapy is crucial in esophageal resection and reconstruction, which is associated with high incidence of postoperative morbidity and mortality. Excessive fluid administration may result in pulmonary complication, while extremely hypovolemia may lead to shock, circulatory dysfunction, and renal damage. Little is known about fluid status will have impact on anastomotic leakage. Goal-directed fluid therapy has shown to benefit perioperative outcome in major abdominal surgery. This study aims to investigate the effect of goal directed fluid management on the postoperative outcome of esophageal resection and reconstruction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cardiac Output Maximization | Experimental | maximize stroke volume, and maintain cardiac index and stroke volume variation during the whole operation |
|
| Cardiac Output Normalization | Active Comparator | keep cardiac index (CI) ≥ 2.2, and maintain CI and stroke volume variation during the whole operation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiac Output Maximization | Other | According to Frank-Starling law, the investigator will administer Voluven 6% 250 mL every 5 minute until stroke volume maximized (stabilized for 20 minutes), and maintain cardiac index and stroke volume variation during the whole operation. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of postoperative complication | Perioperative mortality, anastomotic leakage, pneumonia, respiratory failure, renal dysfunction, and surgical site infection | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative hemodynamic stability | Incidence of intraoperative shock, use of vasopressor or inotropic agents | 1 day |
| Length of stay | Intensive care unit length of stay and hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ya-jung Cheng, M.D., Ph.D | Contact | +886-2-23123456 | 65517 | chengyj@ntu.edu.tw |
| Name | Affiliation | Role |
|---|---|---|
| Ya-jung Cheng, M.D., Ph.D | National Taiwan University Hospital | Principal Investigator |
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| ID | Term |
|---|---|
| D004938 | Esophageal Neoplasms |
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Cardiac Output Normalization | Other | The investigator will administer intravenous fluids to keep cardiac index (CI) ≥ 2.2, and maintain CI and stroke volume variation during the whole operation. |
|
| 1 month |
| D006258 |
| Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |