keyword
https://read.qxmd.com/read/38524770/impact-of-goal-directed-hemodynamic-therapy-on-perioperative-outcomes-in-head-and-neck-free-flap-surgery-a-before-and-after-pilot-study
#1
JOURNAL ARTICLE
Justine Philteos, Stuart A McCluskey, Sophia Emerson, George Djaiani, David Goldstein, Sabri Soussi
BACKGROUND: Free flap reconstruction for head and neck cancer is associated with a high risk of perioperative complications. One of the modifiable risk factors associated with perioperative morbidity is intraoperative hypotension (IOH). The main aim of this pilot study is to determine if the intraoperative use of goal-directed hemodynamic therapy (GDHT) is associated with a reduction in the number of IOH events in this population. METHODS: A before-and-after study design...
March 2024: Health Science Reports
https://read.qxmd.com/read/38512646/comparison-of-dynamic-measures-in-intraoperative-goal-directed-fluid-therapy-of-patients-with-morbid-obesity-undergoing-laparoscopic-sleeve-gastrectomy
#2
JOURNAL ARTICLE
Gökhan Urhan, İsmail Demirel, Ahmet Deniz, Ahmet Aksu, Aysun Yıldız Altun, Esef Bolat, Azize Beştaş, Gülsüm Altuntaş
INTRODUCTION: Obesity increases the risk of morbidity and mortality during surgical procedures. Goal-directed fluid therapy (GDFT) is a new concept for perioperative fluid management that has been shown to improve patient prognosis. This study aimed to investigate the role of the Pleth Variability Index (PVI), systolic pressure variation (SPV), and pulse pressure variation (PPV) in maintaining tissue perfusion and renal function during GDFT management in patients undergoing laparoscopic sleeve gastrectomy (LSG)...
March 21, 2024: Obesity Surgery
https://read.qxmd.com/read/38500033/positive-effects-of-low-dose-s-ketamine-on-preventing-myocardial-injury-after-thoracoscopic-lobectomy-in-patients-aged-70-to-85
#3
JOURNAL ARTICLE
Ziqiang Bi, Lijuan Kong, Jiahui Zhao, Dongdong Song, Fengmei Duan
OBJECTIVE: To investigate the effects of low-dose S-ketamine on marker of myocardial injury (BNP, hs-cTnT and HFABP) after thoracoscopic lobectomy in patients aged 70 to 85. METHODS: One hundred patients (four cases excluded) aged 70-85 years, with body mass index 18-24 kg·m-2 and American Society of Anesthesiologists physical status II-III, scheduled for elective lobectomy from April 2022 to April 2023, were selected. The patients were divided into two groups by a random number table method, namely, the low-dose S-ketamine combined with GDFT group (group S) and the control group (group C), with 48 cases in each group...
March 19, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38492125/effect-of-different-targets-of-goal-directed-fluid-therapy-on-intraoperative-hypotension-and-fluid-infusion-in-robot-assisted-laparoscopic-gynecological-surgery-a-randomized-non-inferiority-trial
#4
JOURNAL ARTICLE
Qi Chen, Bin Wu, Meiling Deng, Ke Wei
Carotid corrected flow time (FTc) and tidal volume challenge pulse pressure variation (VtPPV) are useful clinical parameters for assessing volume status and fluid responsiveness in robot-assisted surgery, but their usefulness as goal-directed fluid therapy (GDFT) targets is unclear. We investigated whether FTc or VtPPV as targets are inferior to PPV in GDFT. This single-center, prospective, randomized, non-inferiority study included 133 women undergoing robot-assisted laparoscopic gynecological surgery in the modified head-down lithotomy position...
March 16, 2024: Journal of Robotic Surgery
https://read.qxmd.com/read/38436757/pulse-pressure-variation-guided-goal-direct-fluid-therapy-decreases-postoperative-complications-in-elderly-patients-undergoing-laparoscopic-radical-resection-of-colorectal-cancer-a-randomized-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Qiu-Rong Wu, Zi-Zuo Zhao, Ke-Ming Fan, Hui-Ting Cheng, Bin Wang
OBJECTIVE: The use of goal-directed fluid therapy (GDFT) has been shown to reduce complications and improve prognosis in high-risk abdominal surgery patients. However, the utilization of pulse pressure variation (PPV) guided GDFT in laparoscopic surgery remains a subject of debate. We hypothesized that utilizing PPV guidance for GDFT would optimize short-term prognosis in elderly patients undergoing laparoscopic radical resection for colorectal cancer compared to conventional fluid therapy...
March 4, 2024: International Journal of Colorectal Disease
https://read.qxmd.com/read/38426709/feasibility-of-goal-directed-fluid-therapy-in-patients-with-transcatheter-aortic-valve-replacement-an-ambispective-analysis
#6
JOURNAL ARTICLE
Ralf Felix Trauzeddel, Michael Nordine, Giovanni B Fucini, Michael Sander, Henryk Dreger, Karl Stangl, Sascha Treskatsch, Marit Habicher
INTRODUCTION: Goal-directed fluid therapy (GDFT) has been shown to reduce postoperative complications. The feasibility of GDFT in transcatheter aortic valve replacement (TAVR) patients under general anesthesia has not yet been demonstrated. We examined whether GDFT could be applied in patients undergoing TAVR in general anesthesia and its impact on outcomes. METHODS: Forty consecutive TAVR patients in the prospective intervention group with GDFT were compared to 40 retrospective TAVR patients without GDFT...
March 1, 2024: Brazilian Journal of Cardiovascular Surgery
https://read.qxmd.com/read/38392609/challenges-in-septic-shock-from-new-hemodynamics-to-blood-purification-therapies
#7
REVIEW
Fernando Ramasco, Jesús Nieves-Alonso, Esther García-Villabona, Carmen Vallejo, Eduardo Kattan, Rosa Méndez
Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i...
February 3, 2024: Journal of Personalized Medicine
https://read.qxmd.com/read/38359801/post-operative-ileus-after-minimally-invasive-colorectal-surgery-a-summary-of-current-strategies-for-prevention-and-management
#8
REVIEW
Eve K Abernethy, Emad H Aly
Background Postoperative ileus (POI) is one of the most common postoperative complications after colorectal surgery and prolongs hospital stays. Minimally invasive surgery (MIS) has reduced POI, but it remains common. This review explores current methods for preventing and managing POI after MIS. Summary Preoperative interventions, including exercise programmes and mechanical bowel preparation (MBP) with oral antibiotics, have a role in preventing POI. Transversus abdominis plane blocks (TAPBs) and lidocaine could replace epidural analgesia in MIS...
February 15, 2024: Digestive Surgery
https://read.qxmd.com/read/38348932/goal-directed-fluid-therapy-guided-by-plethysmographic-variability-index-versus-conventional-liberal-fluid-therapy-in-neonates-undergoing-abdominal-surgery-a-prospective-randomized-controlled-trial
#9
JOURNAL ARTICLE
A S Swathy, Anudeep Jafra, Neerja Bhardwaj, Ravi P Kanojia, Monika Bawa
BACKGROUND: Intraoperative fluid therapy maintains normovolemia, normal tissue perfusion, normal metabolic function, normal electrolytes, and acid-base status. Plethysmographic variability index has been shown to predict fluid responsiveness but its role in guiding intraoperative fluid therapy is still elusive. AIMS: The aim of the present study was to compare intraoperative goal-directed fluid therapy based on plethysmographic variability index with liberal fluid therapy in term neonates undergoing abdominal surgeries...
February 13, 2024: Paediatric Anaesthesia
https://read.qxmd.com/read/38343671/restrictive-versus-goal-directed-fluid-replacement-strategy-in-ovarian-cancer-cytoreductive-surgery-rigorocs-a-randomised-controlled-trial
#10
JOURNAL ARTICLE
Jyotsna Goswami, Angshuman Rudra Pal, Suparna Mitra Barman, Anshuman Sarkar, Viplab Patro, Jaydip Bhowmik, Asima Mukhopadhyay
BACKGROUND: Although goal-directed fluid therapy (GDFT) is associated with reduced morbidity and length of stay (LOS) in the hospital after major surgery, it has not been widely studied in ovarian cancer cytoreductive surgery (CRS). The primary objective of the study was post-operative LOS. METHODS: In this double-blind, randomised controlled trial, ovarian cancer patients undergoing elective CRS were randomised to receive either GDFT or restrictive fluid therapy after pre-randomisation stratification for primary debulking surgery or interval debulking surgery...
December 2023: Indian Journal of Anaesthesia
https://read.qxmd.com/read/38337495/perioperative-fluid-management-in-colorectal-surgery-institutional-approach-to-standardized-practice
#11
REVIEW
Philip Deslarzes, Jonas Jurt, David W Larson, Catherine Blanc, Martin Hübner, Fabian Grass
The present review discusses restrictive perioperative fluid protocols within enhanced recovery after surgery (ERAS) pathways. Standardized definitions of a restrictive or liberal fluid regimen are lacking since they depend on conflicting evidence, institutional protocols, and personal preferences. Challenges related to restrictive fluid protocols are related to proper patient selection within standardized ERAS protocols. On the other hand, invasive goal-directed fluid therapy (GDFT) is reserved for more challenging disease presentations and polymorbid and frail patients...
January 30, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38335896/the-effect-of-goal-directed-fluid-therapy-on-delayed-graft-function-in-kidney-transplant-recipients-a-systematic-review-and-meta-analysis
#12
REVIEW
Michael P Klonarakis, Mannat Dhillon, Emir Sevinc, Meghan J Elliott, Matthew T James, Ngan N Lam, Kevin J McLaughlin, Paul E Ronksley, Shannon M Ruzycki, Tyrone G Harrison
Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant...
February 5, 2024: Transplantation Reviews
https://read.qxmd.com/read/38317166/the-impact-of-goal-directed-fluid-therapy-on-postoperative-pulmonary-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#13
REVIEW
Shuang Han, Xiaoqian Wu, Pan Li, Kun He, Jianli Li
BACKGROUND: Pulmonary complications after thoracic surgery are common and associated with significant morbidity and high cost of care. Goal-directed fluid therapy (GDFT) could reduce the incidence of postoperative pulmonary complications (PPCs) and facilitate recovery in patients undergoing major abdominal surgery. However, whether GDFT could reduce the incidence of PPCs in patients undergoing thoracic surgery was unclear. The present meta-analysis was designed to assess the impact of Goal-directed Fluid Therapy on PPCs in patients undergoing thoracic surgery...
February 5, 2024: Journal of Cardiothoracic Surgery
https://read.qxmd.com/read/38182828/perioperative-quality-indicators-specific-to-the-practice-of-anesthesia-in-noncardiac-surgery-an-umbrella-review
#14
REVIEW
Frederic Nguyen, Gary Liao, Daniel I McIsaac, Manoj M Lalu, Christopher L Pysyk, Gavin M Hamilton
PURPOSE: Improvement in delivery of perioperative care depends on the ability to measure outcomes that can direct meaningful changes in practice. We sought to identify and provide an overview of perioperative quality indicators specific to the practice of anesthesia in noncardiac surgery. SOURCE: We conducted an umbrella review (a systematic review of systematic reviews) according to Joanna Briggs Institute methodology. We included systematic reviews examining perioperative indicators in patients ≥ 18 yr of age undergoing noncardiac surgery...
January 5, 2024: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/38152505/pulse-pressure-variance-ppv-guided-fluid-management-in-adult-patients-undergoing-supratentorial-tumor-surgeries-a-randomized-controlled-trial
#15
JOURNAL ARTICLE
Janani Gopal, Shashi Srivastava, Nidhi Singh, Rudrashish Haldar, Ruchi Verma, Devendra Gupta, Prabhakar Mishra
Objective  Appropriate fluid management in neurosurgery is critical due to the risk of secondary brain injury. Determination of volume status is challenging with static variables being unreliable. Goal-directed fluid therapy with dynamic variables allows reliable determination of fluid responsiveness and promises better outcomes. We aimed to compare the intraoperative fluid requirement between conventional central venous pressure (CVP)-guided and pulse pressure variance (PPV)-guided fluid management in supratentorial tumor surgeries...
September 2023: Asian Journal of Neurosurgery
https://read.qxmd.com/read/38125841/-coagulation-a-mnemonic-device-for-treating-coagulation-disorders-following-traumatic-brain-injury-a-narrative-based-method-in-the-intensive-care-unit
#16
JOURNAL ARTICLE
Manuel Quintana-Diaz, Pasquale Anania, Raúl Juárez-Vela, Emmanuel Echaniz-Serrano, Clara Isabel Tejada-Garrido, Pilar Sanchez-Conde, Kapil Nanwani-Nanwani, Ainhoa Serrano-Lázaro, Pilar Marcos-Neira, María Gero-Escapa, Jorge García-Criado, Daniel Agustín Godoy
INTRODUCTION: Coagulopathy associated with isolated traumatic brain injury (C-iTBI) is a frequent complication associated with poor outcomes, primarily due to its role in the development or progression of haemorrhagic brain lesions. The independent risk factors for its onset are age, severity of traumatic brain injury (TBI), volume of fluids administered during resuscitation, and pre-injury use of antithrombotic drugs. Although the pathophysiology of C-iTBI has not been fully elucidated, two distinct stages have been identified: an initial hypocoagulable phase that begins within the first 24 h, dominated by platelet dysfunction and hyperfibrinolysis, followed by a hypercoagulable state that generally starts 72 h after the trauma...
2023: Frontiers in Public Health
https://read.qxmd.com/read/38106571/real-time-acute-kidney-injury-risk-stratification-biomarker-directed-fluid-management-improves-outcomes-in-critically-ill-children-and-young-adults
#17
JOURNAL ARTICLE
Stuart L Goldstein, Kelli A Krallman, Jean-Philippe Roy, Michaela Collins, Ranjit S Chima, Rajit K Basu, Lakhmir Chawla, Lin Fei
INTRODUCTION: Critically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation...
December 2023: KI Reports
https://read.qxmd.com/read/38091035/goal-directed-fluid-therapy-during-post-resection-phase-in-low-central-venous-pressure-assisted-laparoscopic-hepatectomy-a-randomized-controlled-superiority-trial
#18
RANDOMIZED CONTROLLED TRIAL
Shichao Li, Yue Yin, Pei Wang, Long Jiang, Huan Yan, Jing Cang
PURPOSE: The purpose of this prospective single blinded randomized controlled trial was to find out whether goal-directed fluid therapy (GDFT) strategy in post-transection period in low central venous pressure (CVP) assisted laparoscopic hepatectomy (LH) has more benefit than traditional fluid strategy. METHODS: Between April 2020 and Dec 2021, patients who were scheduled for laparoscopic liver resection surgery were eligible to participate in the study. Patients were randomly divided into two groups: control group that received traditional fluid strategy in post-transection period in low CVP assisted laparoscopic hepatectomy and GDFT strategy group that received GDFT strategy in post-transection period...
February 2024: Journal of Anesthesia
https://read.qxmd.com/read/38085874/modern-fluid-management-in-thoracic-surgery
#19
JOURNAL ARTICLE
Timothy J P Batchelor
PURPOSE OF REVIEW: To provide an approach to perioperative fluid management for lung resection patients that incorporates the entire patient pathway in the context of international guidelines on enhanced recovery after surgery (ERAS). RECENT FINDINGS: The concern with intraoperative fluid management is that giving too little or too much fluid is associated with worse outcomes after lung resection. However, it has not emerged as a key care element in thoracic ERAS programs probably due to the influence of other ERAS elements...
November 27, 2023: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38076120/identification-of-angiogenesis-related-genes-in-diabetic-foot-ulcer-using-machine-learning-algorithms
#20
JOURNAL ARTICLE
Xingkai Wang, Lei Meng, Juewei Zhang, Linxuan Zou, Zhuqiang Jia, Xin Han, Lin Zhao, Mingzhi Song, Zhen Zhang, Junwei Zong, Shouyu Wang, Ming Lu
BACKGROUND: Diabetic foot ulcers (DFUs) are among the most prevalent and dangerous complications of diabetes. Angiogenesis is pivotal for wound healing; however, its role in the chronic wound healing process in DFU requires further investigation. We aimed to investigate the pathogenic processes of angiogenesis in DFU from a molecular biology standpoint and to offer insightful information about DFU prevention and therapy. METHODS: Differential gene and weighted gene co-expression network analyses (WGCNA) were employed to screen for genes related to DFU using the downloaded and collated GSES147890 datasets...
December 2023: Heliyon
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