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|dc.contributor.author||Shen, Shi Hong||-|
|dc.identifier.citation||Annals of medicine and surgery 2019; 45: 45-53||-|
|dc.description.abstract||The effect a restrictive goal directed therapy (GDT) fluid protocol combined with an enhanced recovery after surgery (ERAS) programme on hospital stay for patients undergoing major liver resection is unknown. We conducted a multicentre randomized controlled pilot trial evaluating whether a patient-specific, surgery-specific intraoperative restrictive fluid optimization algorithm would improve duration of hospital stay and reduce perioperative fluid related complications. Forty-eight participants were enrolled. The median (IQR) length of hospital stay was 7.0 days (7.0:8.0) days in the restrictive fluid optimization algorithm group (Restrict group) vs. 8.0 days (6.0:10.0) in the conventional care group (Conventional group) (Incidence rate ratio 0.85; 95% Confidence Interval 0.71:1.1; p = 0.17). No statistically significant difference in expected number of complications per patient between groups was identified (IRR 0.85; 95%CI: 0.45-1.60; p = 0.60). Patients in the Restrict group had lower intraoperative fluid balances: 808 mL (571:1565) vs. 1345 mL (900:1983) (p = 0.04) and received a lower volume of fluid per kg/hour intraoperatively: 4.3 mL/kg/hr (2.6:5.8) vs. 6.0 mL/kg/hr (4.2:7.6); p = 0.03. No significant differences in the proportion of patients who received vasoactive drugs intraoperatively (p = 0.56) was observed. In high-volume hepatobiliary surgical units, the addition of a fluid restrictive intraoperative cardiac output-guided algorithm, combined with a standard ERAS protocol did not significantly reduce length of hospital stay or fluid related complications. Our findings are hypothesis-generating and a larger confirmatory study may be justified.||-|
|dc.title||Goal directed fluid therapy for major liver resection: A multicentre randomized controlled trial.||-|
|dc.identifier.journaltitle||Annals of medicine and surgery||-|
|dc.identifier.affiliation||Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia||en|
|dc.identifier.affiliation||Department of Anesthesia, Peter MacCallum Cancer Hospital, Victoria, Australia||en|
|dc.identifier.affiliation||Statistics and Decision Analysis Academic Platform, The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Victoria, Australia||en|
|dc.identifier.affiliation||Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia||en|
|dc.identifier.affiliation||Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia||en|
|Appears in Collections:||Journal articles|
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