Postoperative Complications
Conditions
Keywords
Goal directed fluid therapy, perioperative fluid therapy, LiDCOrapid, Postoperative outcome, Open abdominal surgery
Brief summary
Is goal directed fluid therapy reducing postoperative complications in comparison to traditional fluid therapy for gastro surgical ASA III/IV patients? The investigators compare two groups of patients: one group receives goal directed fluid therapy guided by LiDCOrapid stroke volume variation (SVV), the other gets the traditional fluids, ie the current regime.
Interventions
PROCEDUREGoal directed fluid therapy guided by LiDCOrapid
Standard monitoring. The patient is connected to the LiDCOrapid monitor via an arterial line placed in a.radialis. A bolus of 500 ml Ringer acetate is given before anesthesia. If the stroke volume (SV) increases more than 10%, repeat the procedure until the SV is not increasing. After that, induction of anesthesia. Maintenance fluid is given as Ringer acetate 2ml/kg/t. Continuous monitoring of stroke volume variation (SVV). If SVV\> 10%, give a fluid bolus 6ml/kg Ringer acetate. Repeat until SVV \<10%. Bleeding is being replaced 1:1 with hydroxyethyl starch. SAG by bleeding \>1000ml. By fall in blood pressure and SVV \<10%, start vasoactive treatment with epinephrine. Postoperative is given Glucose 5% 80ml/h.
Sponsors
Haukeland University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult ASA class III & IV (high risk) patients * \>18 years * scheduled for gastrointestinal surgery involving laparotomy * Both elective and emergency cases
Exclusion criteria
* Atrial fibrillation * Mental impairment, unable to give informed consent * Severe aortic or mitral stenosis * Type of surgery: Liver surgery, transthoracic oesophagectomy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative complications | 5 days after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | 3 month after surgery | — |
| Complications until discharge and readmission within 30 days | 3 month after surgery | — |
| Mortality within 30 days and 3-month after surgery | 3 month after surgery | — |
| Renal function | 5 days after surgery | defined by RIFLE criteria |
| Vasoactive agents need | 3 month after surgery | Difference in the number of patients in need of vasoactive agents, during surgery and in the postoperative period. |
Countries
Finland, Norway
Outcome results
None listed