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.

Basic information

Original name

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

Authors

HRDÝ, Ondřej (203 Czech Republic, belonging to the institution), Miloš DUBA (203 Czech Republic, guarantor, belonging to the institution), Andrea DOLEZELOVA (203 Czech Republic), Ivana ROŠKOVÁ (703 Slovakia, belonging to the institution), Martin HLAVATÝ (203 Czech Republic, belonging to the institution), Rudolf TRAJ (703 Slovakia, belonging to the institution), Vít BÖNISCH (203 Czech Republic, belonging to the institution), Martin SMRČKA (203 Czech Republic, belonging to the institution) and Roman GÁL (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.600 in 2022

RIV identification code

RIV/00216224:14110/23:00131383

Organization unit

Faculty of Medicine

UT WoS

001019955700001

Keywords in English

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

Tags

International impact, Reviewed
Změněno: 9/8/2023 08:25, Mgr. Tereza Miškechová

Abstract

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.

Links

MUNI/A/1421/2022, interní kód MU
Name: Vývoj metod a instrumentace pro analýzu biologicky významných látek 2023
Investor: Masaryk University