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The investigators will do the Goal directed fluid therapy by protocolized fluid management in the experimental group, using PPV to guide the fluid administration, compare with standard fluid management in patients undergoing complex spine surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GDFT group | Experimental | The GDFT group will receive 400 ml of 12.5% carbohydrate drink after 6 pm until the bed time in the day before surgery and 200 ml in the morning of the surgery day. Acetate ringer solution will be start at 7:00. After induction PPV will be measure and fluid bolus 200 ml in 10 minutes will be given if PPV >13 before prone position. During the operation, the patient in GDFT group will receipt fluid therapy according to acceptable PPV |
|
| controlled group | Other | The carbohydrate drink will not be given. Fluid, blood and blood product administration will be under attending anesthesiologist order. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| goal directed fluid therapy | Procedure | pulse pressure variation will be used to as a goal to guide fluid administration in this group |
|
| Measure | Description | Time Frame |
|---|---|---|
| episode of intraoperative hypotension | Blood pressure will be record continuously using arterial catheter in both group. Number of participants and episode of hypotension (defined as SBP < 90 mmHg or MAP < 60 mmHg or decrease of SPB >= 25% from baseline for 5 minutes or need vasopressor) therapy | intraoperative |
| Measure | Description | Time Frame |
|---|---|---|
| unit of blood transfusion | all unit of blood transfusion will be record intraoperative and postoperative | intraoperative and up to 24 hours postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine Siriraj Hospital | Bangkok Noi | Bangkok | 10700 | Thailand |
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| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| ID | Term |
|---|---|
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
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| Controlled | Other | standard fluid treatment by an anesthesiologist |
|
| D008722 | Methods |