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Statements

Subject Item
n2:RIV%2F00216208%3A11140%2F14%3A10281248%21RIV15-MSM-11140___
rdf:type
skos:Concept n12:Vysledek
rdfs:seeAlso
http://ccforum.com/content/pdf/s13054-014-0584-z.pdf
dcterms:description
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.
dcterms: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
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
skos:notation
RIV/00216208:11140/14:10281248!RIV15-MSM-11140___
n3:aktivita
n19:I
n3:aktivity
I
n3:cisloPeriodika
5
n3:dodaniDat
n6:2015
n3:domaciTvurceVysledku
n17:7550561
n3:druhVysledku
n4:J
n3:duvernostUdaju
n9:S
n3:entitaPredkladatele
n10:predkladatel
n3:idSjednocenehoVysledku
13727
n3:idVysledku
RIV/00216208:11140/14:10281248
n3:jazykVysledku
n18:eng
n3:klicovaSlova
postoperative outcome; perioperative goal-directed therapy; dynamic variations
n3:klicoveSlovo
n5:postoperative%20outcome n5:dynamic%20variations n5:perioperative%20goal-directed%20therapy
n3:kodStatuVydavatele
GB - Spojené království Velké Británie a Severního Irska
n3:kontrolniKodProRIV
[F244B18B907C]
n3:nazevZdroje
Critical Care [online]
n3:obor
n13:FP
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
4
n3:rokUplatneniVysledku
n6:2014
n3:svazekPeriodika
18
n3:tvurceVysledku
Giglio, Mariateresa Brienza, Nicola Beneš, Jan Michard, Frederic
s:issn
1466-609X
s:numberOfPages
11
n14:doi
10.1186/s13054-014-0584-z
n15:organizacniJednotka
11140