Can goal-directed fluid therapy decrease the use of blood and hemoderivates in surgical patients?

Can goal-directed fluid therapy decrease the use of blood and hemoderivates in surgical patients? Minerva Anestesiol. 2020 Apr 06;: Authors: Tomescu DR, Scarlatescu E, Bubenek-Turconi ŞI Abstract The purpose of Goal Directed Therapy (GDT) is to improve patient outcome by the optimization of hemodynamic status, as it is considered that many perioperative complications are related to microcirculatory disturbance due to an imbalance between oxygen delivery and consumption. The application of GDT protocols incorporating the assessment and optimization of patients' intravascular status should theoretically lead to a reduction in perioperative bleeding and transfusion requirements, as both hypervolemia and hypovolemia and their consequences such as dilutional coagulopathy, anaemia and inadequate oxygen delivery to the tissues are avoided. However, the research reporting decreased usage of blood products in patients which received targeted fluid management is sparse; decreased blood loss and transfusion requirements were reported in spine surgery using GDT, while studies in abdominal or cardiac surgery did not consistently report significant decreases in blood products transfusion when GDT were applied. These heterogenous results reported can be explained by the differences between the GDT protocols used, as the differences in therapeutic goals can impact on blood transfusion requirements. In the future, the GDT protocols should include no...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research