Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis

Legrand, G; Ruscio, Laura; Benhamou, Dan; Pelletier‐Fleury, Nathalie

doi:10.1016/j.jval.2015.04.005

Cited by 17 publications

(5 citation statements)

References 25 publications

(74 reference statements)

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“…601,602 Monitoring cardiac output with a defined treatment protocol has also been shown to be cost-effective in the setting of major abdominal surgery. 603 Whereas studies focused on the care of patients with an aortic aneurysm have not been conducted, randomized trials have included patients with vascular disease. 604 Fast-track surgical pathways or "enhanced recovery" pathways are being used increasingly to decrease length of stay and to expedite discharge after abdominal surgery.…”

Section: Level Of Recommendation 1 (Strong)mentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Chaikof

Dalman

Eskandari

et al. 2018

Journal of Vascular Surgery

1,880

1,478

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Important new recommendations are provided for the care of patients with an AAA, including suggestions to improve mutual decision-making between the treating physician and the patients and their families as well as a number of new strategies to enhance perioperative outcomes for patients undergoing elective and emergent repair. Areas of uncertainty are highlighted that would benefit from further investigation in addition to existing limitations in diagnostic tests, pharmacologic agents, intraoperative tools, and devices.

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Section: Level Of Recommendation 1 (Strong)mentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Chaikof

Dalman

Eskandari

et al. 2018

Journal of Vascular Surgery

1,880

1,478

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“…Intra-operative CO optimisation and GDFT for patients undergoing colorectal surgery reduces the postoperative morbidity, mortality and length of hospital stay [9] . GDFT has also been shown to be cost effective in reducing hospital stays and the surgical complications [32,33] . It would be interesting to extend this study to use intra-operative cardiac output monitoring for patients undergoing emergency laparotomy and to assess the outcomes through the National Emergency Laparotomy Audit.…”

Section: Discussionmentioning

confidence: 99%

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

Aslam¹,

Smith²,

Currow³

et al. 2018

MIS

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Aim: Intra-operative cardiac output (CO) monitoring became a standard of care in Northampton General Hospital, UK, at the end of 2013. This study aimed to assess the effectiveness of intra-operative CO monitoring with oesophageal Doppler or LiDCO for patients undergoing elective colorectal surgery for cancer within an enhanced recovery after surgery (ERAS).Methods: Data was prospectively collected over a 5-year period (March 2010 -Feb 2015 for patients undergoing elective colorectal surgery in the practice of a single surgeon. The ERAS protocol was applied for all the patients. There were 69 patients who had intra-operative CO monitoring with oesophageal Doppler or LiDCO and 144 patients who had no intra-operative CO monitoring. Results were analysed for post-operative outcomes (morbidity, mortality, readmission within 30 days, total length of hospital stay and admission to a high level of care facility). Results:There was no significant difference in 30-day morbidity and readmission rates between the two examined groups. Forty-six percent of patients in the intra-operative CO monitoring group were admitted to a low level of care facility (ward) in comparison to 24% of patients in the no intra-operative CO monitoring group (P = 0.01). Conclusion:Using intra-operative CO monitoring singnificantly might reduce the need for admission to critical care. A larger cohort study is needed to further confirm these findings and account for any co-founders.

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“…Moreover, it is invasive and can lead to numerous complications such as thrombosis, pulmonary artery rupture, infection, and arrhythmia on insertion [51]. Therefore, other minimal or noninvasive hemodynamic monitoring systems have been developed [65,66]. In the section below, we will focus on common and popular monitoring systems which have been verified and used preoperatively for GDFT.…”

Section: Goal-directed Fluid Therapy Monitoring Systemsmentioning

confidence: 99%

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

Kan¹,

Skaggs²

2023

Yale J Biol Med

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Goal-directed fluid therapy (GDFT) is usually recommended in patients undergoing major surgery and is essential in enhanced recovery after surgery (ERAS) protocols. This fluid regimen is usually guided by dynamic hemodynamic parameters and aims to optimize patients' cardiac output to maximize oxygen delivery to their vital organs. While many studies have shown that GDFT benefits patients perioperatively and can decrease postoperative complications, there is no consensus on which dynamic hemodynamic parameters to guide GDFT with. Furthermore, there are many commercialized hemodynamic monitoring systems to measure these dynamic hemodynamic parameters, and each has its pros and cons. This review will discuss and review the commonly used GDFT dynamic hemodynamic parameters and hemodynamic monitoring systems.

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Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis

Cited by 17 publications

References 25 publications

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

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