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Year : 2022  |  Volume : 11  |  Issue : 2  |  Page : 52-58

Goal-directed fluid therapy in gastrointestinal cancer surgery: A prospective randomized study

1 Department of Anesthesiology and Reanimation, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
2 Department of Anesthesiology and Reanimation, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
3 Department of Critical Care Medicine, Marmara University Pendik Training and Research Hospital, Marmara University School of Medicine, Istanbul, Turkey

Correspondence Address:
Duygu Akyol
Department of Anesthesiology and Reanimation, Başakşehir Çam and Sakura City Hospital, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2221-6189.342661

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Objective: To investigate the effects of perioperative goal-directed fluid therapy (GDFT) on intraoperative fluid balance, postoperative morbidity, and mortality. Methods: This is a prospective randomized study, and 90 patients who underwent elective open gastrointestinal cancer surgery between April 2017 and May 2018 were included. Patients were randomized into 2 groups that received liberal fluid therapy (the LFT group, n=45) and goal-directed fluid therapy (the GDFT group, n=45). Patients’ Colorectal Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) physiological score, Charlson Comorbidity Index (CCI), perioperative vasopressor and inotrope use, postoperative AKIN classification, postoperative intensive care unit (ICU) hospitalization, hospital stay, and 30-day mortality were recorded. Results: The volume of crystalloid used perioperatively and the total volume of fluid were significantly lower in the GDFT group compared to the LFT group (P<0.05). CR-POSSUM physiological score and CCI were significantly higher in the GDFT group (P<0.05). Although perioperative vasopressor and inotrope use was significantly higher in the GDFT group (P<0.05), postoperative acute kidney injury development was not affected. Postoperative mortality was determined to be similar in both groups (P>0.05). Conclusion: Although GDFT was demonstrated to be a good alternative method to LFT in open gastrointestinal cancer surgery, and it can prevent perioperative fluid overload, and the postoperative results are comparable in the two groups.

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