Zhang J, Li XW, Xie BF. The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery. World J Gastrointest Surg 2024; 16(9): 2815-2822 [DOI: 10.4240/wjgs.v16.i9.2815]
Corresponding Author of This Article
Jun Zhang, BM BCh, Department of Anesthesiology, The Second Hospital of Longyan, Room 606, Building B, Dongcheng Yinhe Garden, Xinluo District, Longyan 364000, Fujian Province, China. 13799071729@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2815-2822 Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2815
The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery
Jun Zhang, Xiao-Wen Li, Bing-Feng Xie
Jun Zhang, Bing-Feng Xie, Department of Anesthesiology, The Second Hospital of Longyan, Longyan 364000, Fujian Province, China
Xiao-Wen Li, Department of Gastrointestinal Surgery, Longyan First Hospital, Longyan 364000, Fujian Province, China
Author contributions: Zhang J, Li XW, Xie BF designed the research; Zhang J performed the research; Xie BF contributed new reagents/analytic tools; Li XW analyzed the data; Zhang J wrote the paper.
Institutional review board statement: The study was reviewed and approved by The Second Hospital of Longyan.
Informed consent statement: Signed informed consent was obtained from all participants.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: Not applicable.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Zhang, BM BCh, Department of Anesthesiology, The Second Hospital of Longyan, Room 606, Building B, Dongcheng Yinhe Garden, Xinluo District, Longyan 364000, Fujian Province, China. 13799071729@163.com
Received: July 23, 2024 Revised: August 15, 2024 Accepted: August 16, 2024 Published online: September 27, 2024 Processing time: 56 Days and 13.9 Hours
Abstract
BACKGROUND
Intraoperative fluid management is an important aspect of anesthesia management in gastrointestinal surgery. Intraoperative goal-directed fluid therapy (GDFT) is a method for optimizing a patient's physiological state by monitoring and regulating fluid input in real-time.
AIM
To evaluate the efficacy of intraoperative GDFT in patients under anesthesia for gastrointestinal surgery.
METHODS
This study utilized a retrospective comparative study design and included 60 patients who underwent gastrointestinal surgery at a hospital. The experimental group (GDFT group) and the control group, each comprising 30 patients, received intraoperative GDFT and traditional fluid management strategies, respectively. The effect of GDFT was evaluated by comparing postoperative recovery, complication rates, hospitalization time, and other indicators between the two patient groups.
RESULTS
Intraoperative blood loss in the experimental and control groups was 296.64 ± 46.71 mL and 470.05 ± 73.26 mL (P < 0.001), and urine volume was 415.13 ± 96.72 mL and 239.15 ± 94.69 mL (P < 0.001), respectively. The postoperative recovery time was 5.44 ± 1.1 days for the experimental group compared to 7.59 ± 1.45 days (P < 0.001) for the control group. Hospitalization time for the experimental group was 10.87 ± 2.36 days vs 13.65 ± 3 days for the control group (P < 0.001). The visual analogue scale scores of the experimental and control groups at 24 h and 48 h post-surgery were 3.38 ± 0.79 and 4.51 ± 0.86, and 2.05 ± 0.57 and 3.51 ± 0.97 (P < 0.001), respectively. The cardiac output of the experimental and control groups was 5.99 ± 1.04 L/min and 4.88 ± 1.17 L/min, respectively, while the pulse pressure variability for these two groups was 10.87 ± 2.36% and 17.5 ± 3.21%, respectively.
CONCLUSION
The application of GDFT in gastrointestinal surgery can significantly improve postoperative recovery, reduce the incidence of complications, and shorten hospital stays.
Core Tip: In this study, intraoperative goal-directed fluid therapy (GDFT) showed significant clinical benefits in gastrointestinal surgery, including reduced intraoperative bleeding, accelerated postoperative recovery, and alleviated postoperative pain. This fluid management strategy helped maintain patients’ hemodynamic stability, reduced the incidence of intraoperative and postoperative complications, and improved the success rate of surgical treatment and patients’ quality of life. However, the establishment of specific implementation methods and standards for GDFT requires further research and optimization to ensure safety and efficacy and to provide more accurate guidance for its clinical application.
