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This study aims to compare two different methods for guiding intravenous (IV) fluid therapy in patients during their first 6 hours in the ICU after major abdominal surgery. The goal is to determine which method leads to a more optimal and precise amount of fluid administration. The objective is to compare the total fluid volumes administered when guided by Cardiac Index versus Central Venous Pressure, as well as mortality, length of stay, relaparotomy and reintubation in order to identify the more precise fluid management strategy for postoperative ICU patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A (Cardiac Index) | Experimental | During the first 6 hours postoperatively in the ICU, patients will receive fluid following a Goal-Directed Fluid Therapy (GDFT) protocol, with a target Cardiac Index of 2.5 to 4.0 L/min/m². |
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| Group B (Central Venous Pressure) | Active Comparator | During the first 6 hours postoperatively in the ICU, patients will receive fluid following a Goal-Directed Fluid Therapy (GDFT) protocol, with a target Central Venous Pressure (CVP) of 8-12 mmHg. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Goal-Directed Fluid Therapy (GDFT) | Procedure | For the 6-hour intervention period, patients will receive fluid according to a Goal-Directed Fluid Therapy (GDFT) protocol. The treatment group will be managed to a target Cardiac Index of 2.5-4.0 L/min/m², while the control group will be managed to a target Central Venous Pressure (CVP) of 8-12 mmHg. All patients will receive a maintenance fluid volume of 25 mL/kg/24 hours, which will comprise the total volume from both parenteral fluids and enteral nutrition. |
| Measure | Description | Time Frame |
|---|---|---|
| Total Intravenous Fluid Volume in the ICU | The cumulative volume of intravenous fluids administered, recorded for both the initial 6-hour study period and the total ICU stay. Data will be obtained from ICU charts and recorded as a numerical value (mL). | From ICU enrollment until ICU discharge, up to 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| ICU Mortality | From ICU enrollment until ICU discharge, up to 30 days | |
| ICU Length of Stay | From ICU enrollment until ICU discharge, up to 30 days | |
| Relaparotomy |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sidharta Kusuma Manggala, dr. | Contact | +6281281772295 | maninjau3@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cipto Mangunkusumo Hospital | Recruiting | Jakarta Pusat | DKI Jakarta | 10430 | Indonesia |
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The occurrence of a relaparotomy procedure during the ICU stay, prior to step-down to a general ward. |
| From ICU enrollment until ICU discharge, up to 30 days |
| Reintubation | The occurrence of a reintubation during the ICU stay, prior to step-down to a general ward. | From ICU enrollment until ICU discharge, up to 30 days |