Goal-directed therapy during transthoracic oesophageal resection does not improve outcome: Randomised controlled trial
BACKGROUND
Goal-directed therapy (GDT) is expected to be of highest benefit in high-risk surgery. Therefore, GDT is recommended during oesophageal resection, which carries a high risk of postoperative complications.
OBJECTIVES
The aim of this study was to confirm the hypothesis that GDT during oesophageal resection improves outcome compared with standard care.
DESIGN
A randomised controlled study.
SETTING
Two Swedish university hospitals, between October 2011 and October 2015.
PATIENTS
Sixty-four patients scheduled for elective transthoracic oesophageal resection were randomised. Exclusion criteria included colonic interposition and significant aortic or mitral valve insufficiency.
INTERVENTION
A three-step GDT protocol included stroke volume optimisation using colloid boluses as assessed by pulse-contour analysis, dobutamine infusion if cardiac index was below 2.5 l min−1 m−2 and norepinephrine infusion if mean arterial blood pressure was below 65 mmHg.
MAIN OUTCOME MEASURE
The incidence of complications per patient at 5 and 30 days postoperatively as assessed using a predefined list.
RESULTS
Fifty-nine patients were available for analysis. Patients in the intervention group received more colloid fluid (2190 ± 875 vs. 1596 ± 759 ml, P
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Monitoring Source Type: research
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