TITLE:
Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety
AUTHORS:
Kenji Ito, Miho Ito, Aki Ando, Yuki Sakuma, Toshiyasu Suzuki
KEYWORDS:
FloTrac/Vigileo, Fluid Management, Goal-Directed Therapy, Patient Outcome
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.7 No.1,
January
24,
2017
ABSTRACT: Purpose: We investigated whether the
simplified intraoperative Goal-Directed Therapy (GDT) could improve the factors affecting medical costs, and contribute
in standardizing intraoperative fluid management. Methods: The enrolled patients underwent esophagectomy,
pancreatoduodenectomy, or aortic stent grafting in 2012, and between March 2013
and October 2014. We conducted a comparison study on the effects of GDT,
between the before-GDT historical control group (n = 100) and GDT group (n = 100). The hemodynamic indices used for control
group patients were conventional: Blood pressure, heart rate, and urine output.
For GDT group, additionally, we used stroke volume variation (SVV) and stroke
volume index (SVI). The primary outcomes were the length of intensive care unit
(ICU) stay and hospital stay (LOS). Regression analysis was used to identify
factors affecting LOS. The secondary outcomes were the albumin use, the fluid
amount administered, and the variation in the fluid administration rate. Results: The control and GDT groups
comprised 96 and 99 patients, respectively. The patient characteristics were
similar. The length of ICU stay was significantly shorter (2.1 ± 2.1 days vs.
2.8 ± 1.9 days, P = 0.0009) and LOS was
shorter but without statistical significance (24.5 ± 17.7 days vs. 27.7 ± 20.1
days, P = 0.21) in the GDT group
than in the control group. The fluid amount administered and the presence/ absence of albumin use
were factors affecting LOS. The variation of the fluid administration rate was
significantly lower in the GDT group. Conclusion: The simplified GDT may contribute to the improvement
of medical economics and standardize the fluid management.