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The investigators conduct this randomized assessor-blinded controlled trial to evaluate the effect of SVV-guided fluid therapy on postoperative morbidity and mortality in comparison with conventional fluid therapy after major abdominal surgery. Half of participants will receive GDFT perioperatively, and the others will receive conventional fluid therapy
Perioperative fluid management has been recognized as an important factor with an impact on postoperative recovery following major abdominal surgery. However, the optimal fluid management is difficult to achieve using standard parameters (e.g., heart rate [HR], blood pressure [BP], central venous pressure[CVP], or urine output) that poorly estimate preload and preload responsiveness. Goal-directed fluid therapy (GDFT) was proposed by introducing different hemodynamic variables into a dynamic perspective of individual fluid loading with or without vasoactive substances to reach predefined goal of optimal preload and/or oxygen delivery.There have been increasing numbers of studies evaluating the effect of perioperative GDFT on postoperative recovery following major abdominal surgery. However, the evidence for the beneficial effect of GDFT on postoperative recovery remains inconsistent.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| goal-directed fluid therapy | Experimental | Stroke Volume variation (SVV)-guided fluid therapy |
|
| Conventional fluid therapy | Active Comparator | Conventional fluid therapy such as CVP and MAP guided fluid therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| the enhanced flow-based hemodynamic parameters of the FloTrac/Vigileo device | Device | Stroke volume variation (SVV)-guided fluid therapy |
|
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | from the end of surgery to discharge from hospital | from the end of surgery to discharge from hospital up to 30 days after surgery |
| GI function | number of participants with I-FEED score >6 | from the end of surgery to 30 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| mortality | death after surgery | from the end of surgery to 1 year after surgery |
| postoperative pain score | VAS for pain :0 no pain and 10 for worst pain |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yanxia Sun, M.D. | Beijing Tong Ren Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Tongren Hospital | Beijing | Beijing Municipality | 100730 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38049713 | Derived | Sun Y, Liang X, Chai F, Shi D, Wang Y. Goal-directed fluid therapy using stroke volume variation on length of stay and postoperative gastrointestinal function after major abdominal surgery-a randomized controlled trial. BMC Anesthesiol. 2023 Dec 4;23(1):397. doi: 10.1186/s12871-023-02360-1. |
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goal-directed fluid therapy guided by stroke volume variation and cardiac index using FloTrac/Vigileo monitor
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Care providers and investigators in the operating room could not be blinded due to the presence of the cardiac index trending monitor. The postoperative assessors were blinded to the allocation.
| 1 day, 3 days and 5 days after surgery |
| postoperative recovery quality | QoR-15 :quality of recovery score : 0 worst recovery quality and 150 for best recovery | 1 day, 3 days and 5 days after surgery |
| Postoperative complications | number of any complications after surgery | from end of surgery to 30 days after surgery |