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Controlling the amount of fluids given to patients in perioperative setting can significantly influence their outcomes.
To overcome these problems and avoid the complications of over or underhydration, we use the Goal-directed fluid therapy(GDFT) guided by Inferior vena cava(IVC) collapsibility index approach in which dynamic parameters of volume responsiveness as a guide for fluid therapy. This will ensure that the fluids given were deficient from the circulation and improve the recovery of the patients according to enhanced recovery after surgery(ERAS) protocols.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GD Group | Active Comparator | Patients will take oral clear fluids with carbohydrates content 2 hours preoperatively and intraoperative fluid intake will be guided by Inferior vena cava(IVC) diameter. |
|
| C Group | Active Comparator | the standard fluid management group patients will be fasting 6 hours preoperatively and will receive intraoperative fluid in standard manner. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Goal-Directed Fluid Therapy guided by Inferior Vena Cava Collapsibility Index | Procedure | Measuring Inferior vena cava(IVC) diameter using ultrasound then calculation Inferior vena cava(IVC) collapsibility index and administer fluid accordingly. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Arterial Blood Pressure | intraoperative mean arterial blood pressure measured in mmHg | intraoperatively every 5 minutes |
| Quality of Recovery-40 score(QoR-40) | QoR-40 score ranges from 40 to 200, the higher the score the better the outcome | 24 hours postoperative |
| Heart Rate | intraoperative heart rate will be continuously monitored and recorded every 5 minutes | intraoperatively every 5 minutes |
| Post Anesthesia Care Unit(PACU) Stay | time spent in PACU after surgery measured in minutes | 2 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total fluid intake during operation | Total fluid intake during operation | intraoperatively |
| Number of patients that needed Ephedrine or Atropine | Number of patients that needed Ephedrine or Atropine intraoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mahmoud Abdelkader, MBBCh | Contact | 00201553638376 | mahmoud.ab.ali@gmail.com | |
| Alshaimaa Kamel, MD. | Contact | 01005593169 | 002 | AlshaimaaKamel80@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Mahmoud Abdelkader, MBBCh | Anesthesia, Intensive Care and Pain Management department, Faculty of Medicine, Zagazig University | Principal Investigator |
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| ID | Term |
|---|---|
| D004487 | Edema |
| D020896 | Hypovolemia |
| D012773 | Shock, Surgical |
| ID | Term |
|---|---|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010335 | Pathologic Processes |
| D011183 | Postoperative Complications |
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| standard fluid management | Procedure | standard fluid management |
|
| intraoperatively |
| Peripheral perfusion index | Peripheral Perfusion Index (PPI) is defined as "the ratio of pulsatile blood flow to the non-pulsatile blood flow". It ranges from 0.02% to 20% and it is measured using specific types pulse oximetry and it reflects the perfusion status of the body. | Intraoperatively |
| Length of hospital stay | the number of days from day of surgery until patient's discharge from hospital | the patient will be followed up for 60 days from day of surgery |
| D012769 | Shock |