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@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 and 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, vol.~12, No~1, p.~1-9. ISSN~2047-0525. Available from: https://dx.doi.org/10.1186/s13741-023-00321-3.
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