Effects of goal-directed fluid management guided by a
non-invasive device on the incidence of postoperative
complications in neurosurgery: a pilot and feasibility
randomized controlled trial

J 2023

Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial

HRDÝ, Ondřej, Miloš DUBA, Andrea DOLEZELOVA, Ivana ROŠKOVÁ, Martin HLAVATÝ et. al.

Základní údaje

Originální název

Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial

Autoři

HRDÝ, Ondřej (203 Česká republika, domácí), Miloš DUBA (203 Česká republika, garant, domácí), Andrea DOLEZELOVA (203 Česká republika), Ivana ROŠKOVÁ (703 Slovensko, domácí), Martin HLAVATÝ (203 Česká republika, domácí), Rudolf TRAJ (703 Slovensko, domácí), Vít BÖNISCH (203 Česká republika, domácí), Martin SMRČKA (203 Česká republika, domácí) a Roman GÁL (203 Česká republika, domácí)

Vydání

PERIOPERATIVE MEDICINE, London, BMC, 2023, 2047-0525

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.600 v roce 2022

Kód RIV

RIV/00216224:14110/23:00131383

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1186/s13741-023-00321-3

UT WoS

001019955700001

Klíčová slova anglicky

Complications; Goal-directed therapy; Hemodynamic monitoring; Neuro-anesthesia; Neurosurgery; Postoperative outcome

Štítky

14110224, 14110233, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 9. 8. 2023 08:25, Mgr. Tereza Miškechová

Anotace

V originále

BackgroundThe positive effects of goal-directed hemodynamic therapy (GDHT) on patient-orientated outcomes have been demonstrated in various clinical scenarios; however, the effects of fluid management in neurosurgery remain unclear. Therefore, this study was aimed at assessing the safety and feasibility of GDHT using non-invasive hemodynamic monitoring in elective neurosurgery. The incidence of postoperative complications was compared between GDHT and control groups.MethodsWe conducted a single-center randomized pilot study with an enrollment target of 34 adult patients scheduled for elective neurosurgery. We randomly assigned the patients equally into control and GDHT groups. The control group received standard therapy during surgery and postoperatively, whereas the GDHT group received therapy guided by an algorithm based on non-invasive hemodynamic monitoring. In the GDHT group, we aimed to achieve and sustain an optimal cardiac index by using non-invasive hemodynamic monitoring and bolus administration of colloids and vasoactive drugs. The number of patients with adverse events, feasibility criteria, perioperative parameters, and incidence of postoperative complications was compared between groups.ResultsWe successfully achieved all feasibility criteria. The GDHT protocol was safe, because no patients in either group had unsatisfactory brain tissue relaxation after surgery or brain edema requiring therapy during surgery or 24 h after surgery. Major complications occurred in two (11.8%) patients in the GDHT group and six (35.3%) patients in the control group (p = 0.105).ConclusionsOur results suggested that a large randomized trial evaluating the effects of GDHT on the incidence of postoperative complications in elective neurosurgery should be safe and feasible. The rate of postoperative complications was comparable between groups.

Návaznosti

MUNI/A/1421/2022, interní kód MU

Název: Vývoj metod a instrumentace pro analýzu biologicky významných látek 2023

Investor: Masarykova univerzita, Vývoj metod a instrumentace pro analýzu biologicky významných látek 2023

Citovat

HRDÝ, Ondřej, Miloš DUBA, Andrea DOLEZELOVA, Ivana ROŠKOVÁ, Martin HLAVATÝ, Rudolf TRAJ, Vít BÖNISCH, Martin SMRČKA a Roman GÁL. Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial. PERIOPERATIVE MEDICINE. London: BMC, 2023, roč. 12, č. 1, s. 1-9. ISSN 2047-0525. Dostupné z: https://dx.doi.org/10.1186/s13741-023-00321-3.

@article{2301597,
   author = {Hrdý, Ondřej and Duba, Miloš and Dolezelova, Andrea and Rošková, Ivana and Hlavatý, Martin and Traj, Rudolf and Bönisch, Vít and Smrčka, Martin and Gál, Roman},
   article_location = {London},
   article_number = {1},
   doi = {http://dx.doi.org/10.1186/s13741-023-00321-3},
   keywords = {Complications; Goal-directed therapy; Hemodynamic monitoring; Neuro-anesthesia; Neurosurgery; Postoperative outcome},
   language = {eng},
   issn = {2047-0525},
   journal = {PERIOPERATIVE MEDICINE},
   title = {Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial},
   url = {https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-023-00321-3},
   volume = {12},
   year = {2023}
}

TY  - JOUR
ID  - 2301597
AU  - Hrdý, Ondřej - Duba, Miloš - Dolezelova, Andrea - Rošková, Ivana - Hlavatý, Martin - Traj, Rudolf - Bönisch, Vít - Smrčka, Martin - Gál, Roman
PY  - 2023
TI  - Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial
JF  - PERIOPERATIVE MEDICINE
VL  - 12
IS  - 1
SP  - 1-9
EP  - 1-9
PB  - BMC
SN  - 20470525
KW  - Complications
KW  - Goal-directed therapy
KW  - Hemodynamic monitoring
KW  - Neuro-anesthesia
KW  - Neurosurgery
KW  - Postoperative outcome
UR  - https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-023-00321-3
N2  - BackgroundThe positive effects of goal-directed hemodynamic therapy (GDHT) on patient-orientated outcomes have been demonstrated in various clinical scenarios; however, the effects of fluid management in neurosurgery remain unclear. Therefore, this study was aimed at assessing the safety and feasibility of GDHT using non-invasive hemodynamic monitoring in elective neurosurgery. The incidence of postoperative complications was compared between GDHT and control groups.MethodsWe conducted a single-center randomized pilot study with an enrollment target of 34 adult patients scheduled for elective neurosurgery. We randomly assigned the patients equally into control and GDHT groups. The control group received standard therapy during surgery and postoperatively, whereas the GDHT group received therapy guided by an algorithm based on non-invasive hemodynamic monitoring. In the GDHT group, we aimed to achieve and sustain an optimal cardiac index by using non-invasive hemodynamic monitoring and bolus administration of colloids and vasoactive drugs. The number of patients with adverse events, feasibility criteria, perioperative parameters, and incidence of postoperative complications was compared between groups.ResultsWe successfully achieved all feasibility criteria. The GDHT protocol was safe, because no patients in either group had unsatisfactory brain tissue relaxation after surgery or brain edema requiring therapy during surgery or 24 h after surgery. Major complications occurred in two (11.8%) patients in the GDHT group and six (35.3%) patients in the control group (p = 0.105).ConclusionsOur results suggested that a large randomized trial evaluating the effects of GDHT on the incidence of postoperative complications in elective neurosurgery should be safe and feasible. The rate of postoperative complications was comparable between groups.
ER  -

HRDÝ, Ondřej, Miloš DUBA, Andrea DOLEZELOVA, Ivana ROŠKOVÁ, Martin HLAVATÝ, Rudolf TRAJ, Vít BÖNISCH, Martin SMRČKA a Roman GÁL. Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial. \textit{PERIOPERATIVE MEDICINE}. London: BMC, 2023, roč.~12, č.~1, s.~1-9. ISSN~2047-0525. Dostupné z: https://dx.doi.org/10.1186/s13741-023-00321-3.

Podrobný výpis o publikaci