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  • Dynamic predictors of fluid responsiveness, namely systolic pressure variation, pulse pressure variation, stroke volume variation and pleth variability index have been shown to be useful to identify in advance patients who will respond to a fluid load by a significant increase in stroke volume and cardiac output. As a result, they are increasingly used to guide fluid therapy. Several randomized controlled trial have tested the ability of goal-directed fluid therapy (GDFT) based on dynamic parameters (GDFTdyn) to improve post-surgical outcome. These studies have yielded conflicting results. Therefore we performed this meta-analysis to investigate whether the use of GDFTdyn is associated with a decrease in post-surgical morbidity.MethodsA systematic literature review, using MEDLINE, EMBASE, and The Cochrane Library databases through September 2013 was conducted. Data synthesis was obtained by using Odds Ratio (OR) and Weighted Mean Difference (WMD) with 95% confidence interval (CI) by random-effects model.ResultsIn total, fourteen studies met the inclusion criteria (961 participants). Post-operative morbidity was reduced by GDFTdyn (OR 0.51; CI 0.34 to 0.75; P <0.001). This effect was related to a significant reduction in infectious (OR 0.45; CI 0.27 to 0.74; P =0.002), cardiovascular (OR 0.55; CI 0.36 to 0.82; P =0.004) and abdominal (OR 0.56; CI 0.37 to 0.86; P =0.008) complications. It was associated with a significant decrease in ICU length of stay (WMD ?0.75?days; CI ?1.37 to ?0.12; P =0.02).ConclusionsIn surgical patients, we found that GDFTdyn decreased post-surgical morbidity and ICU length of stay. Because of the heterogeneity of studies analyzed, large prospective clinical trials would be useful to confirm our findings.
  • Dynamic predictors of fluid responsiveness, namely systolic pressure variation, pulse pressure variation, stroke volume variation and pleth variability index have been shown to be useful to identify in advance patients who will respond to a fluid load by a significant increase in stroke volume and cardiac output. As a result, they are increasingly used to guide fluid therapy. Several randomized controlled trial have tested the ability of goal-directed fluid therapy (GDFT) based on dynamic parameters (GDFTdyn) to improve post-surgical outcome. These studies have yielded conflicting results. Therefore we performed this meta-analysis to investigate whether the use of GDFTdyn is associated with a decrease in post-surgical morbidity.MethodsA systematic literature review, using MEDLINE, EMBASE, and The Cochrane Library databases through September 2013 was conducted. Data synthesis was obtained by using Odds Ratio (OR) and Weighted Mean Difference (WMD) with 95% confidence interval (CI) by random-effects model.ResultsIn total, fourteen studies met the inclusion criteria (961 participants). Post-operative morbidity was reduced by GDFTdyn (OR 0.51; CI 0.34 to 0.75; P <0.001). This effect was related to a significant reduction in infectious (OR 0.45; CI 0.27 to 0.74; P =0.002), cardiovascular (OR 0.55; CI 0.36 to 0.82; P =0.004) and abdominal (OR 0.56; CI 0.37 to 0.86; P =0.008) complications. It was associated with a significant decrease in ICU length of stay (WMD ?0.75?days; CI ?1.37 to ?0.12; P =0.02).ConclusionsIn surgical patients, we found that GDFTdyn decreased post-surgical morbidity and ICU length of stay. Because of the heterogeneity of studies analyzed, large prospective clinical trials would be useful to confirm our findings. (en)
Title
  • The effects of goal directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials
  • The effects of goal directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials (en)
skos:prefLabel
  • The effects of goal directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials
  • The effects of goal directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials (en)
skos:notation
  • RIV/00216208:11140/14:10281248!RIV15-MSM-11140___
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I
http://linked.open...iv/cisloPeriodika
  • 5
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
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http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
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  • 13727
http://linked.open...ai/riv/idVysledku
  • RIV/00216208:11140/14:10281248
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  • postoperative outcome; perioperative goal-directed therapy; dynamic variations (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • GB - Spojené království Velké Británie a Severního Irska
http://linked.open...ontrolniKodProRIV
  • [F244B18B907C]
http://linked.open...i/riv/nazevZdroje
  • Critical Care [online]
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
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http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 18
http://linked.open...iv/tvurceVysledku
  • Beneš, Jan
  • Michard, Frederic
  • Brienza, Nicola
  • Giglio, Mariateresa
issn
  • 1466-609X
number of pages
http://bibframe.org/vocab/doi
  • 10.1186/s13054-014-0584-z
http://localhost/t...ganizacniJednotka
  • 11140
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