Variability in practice and factors predictive of total crystalloid administration during abdominal surgery: retrospective two-centre analysis

Lilot, Marc; Ehrenfeld, Jesse M.; Lee, C.; Harrington, Brian E.; Cannesson, Maxime; Rinehart, Joseph

doi:10.1093/bja/aeu452

Cited by 128 publications

(87 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on our algorithm, the initial administration rate of maintenance fluid was 8 mL/kg/h of crystalloid solution. The overall maintenance rate of fluid administration consequently was 9.2 ± 2.7 mL/kg/h, which was higher than the rate reported by a study conducted in the United States [15]. Modifying our rate setting may further contribute to the reduction in the LOS.…”

Section: Discussionmentioning

confidence: 65%

“…This is an important issue that merits further investigation. Lilot et al [15] In particular, regression analysis performed in all patients suggested that albumin use affected the LOS. To our knowledge, there has been no report to date focusing in detail on the effects of GDT on intraoperative albumin dosage or standardization of fluid management [16].…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety

Ito¹,

Ito²,

Ando³

et al. 2017

OJAnes

View full text Add to dashboard Cite

Purpose: We investigated whether the simplified intraoperative Goal-Directed Therapy (GDT) could improve the factors affecting medical costs, and contribute in standardizing intraoperative fluid management. Methods: The enrolled patients underwent esophagectomy, pancreatoduodenectomy, or aortic stent grafting in 2012, and between March 2013 and October 2014. We conducted a comparison study on the effects of GDT, between the before-GDT historical control group (n = 100) and GDT group (n = 100). The hemodynamic indices used for control group patients were conventional: Blood pressure, heart rate, and urine output. For GDT group, additionally, we used stroke volume variation (SVV) and stroke volume index (SVI). The primary outcomes were the length of intensive care unit (ICU) stay and hospital stay (LOS). Regression analysis was used to identify factors affecting LOS. The secondary outcomes were the albumin use, the fluid amount administered, and the variation in the fluid administration rate. Results: The control and GDT groups comprised 96 and 99 patients, respectively. The patient characteristics were similar. The length of ICU stay was significantly shorter (2.1 ± 2.1 days vs. 2.8 ± 1.9 days, P = 0.0009) and LOS was shorter but without statistical significance (24.5 ± 17.7 days vs. 27.7 ± 20.1 days, P = 0.21) in the GDT group than in the control group. The fluid amount administered and the presence/ absence of albumin use were factors affecting LOS. The variation of the fluid administration rate was significantly lower in the GDT group. Conclusion: The simplified GDT may contribute to the improvement of medical economics and standardize the fluid management.

show abstract

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 97%

Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety

Ito¹,

Ito²,

Ando³

et al. 2017

OJAnes

View full text Add to dashboard Cite

show abstract

“…This variability in practice should not be considered to be a trivial problem as it may lead to an increased risk of worsened patient outcome. For example, a recent study showed that the anesthesia providers were the strongest predictor of the wide variability associated with the intraoperative fluid administration [10]. We should therefore redouble our efforts to reduce such variability in order to improve the quality of medical care and patient safety [11].…”

Section: Discussionmentioning

confidence: 99%

Impact of advanced monitoring variables on intraoperative clinical decision-making: an international survey

Joosten

Desebbe

Suehiro

et al. 2015

J Clin Monit Comput

View full text Add to dashboard Cite

“…In surgery, evidence of current practice in the US shows a very messy state with huge individual differences in the amount of fluids administered to similar patients for similar surgical procedures (11). Interestingly, the most important predictor of how much fluids an individual patient receives seems to be the provider of anaesthesia.…”

Section: Current Practicementioning

confidence: 99%

Current concepts in fluid therapy and non-invasive haemodynamic monitoring

2017

View full text Add to dashboard Cite

Advantages of goal directed therapy (GDT) have recently become more and more difficult to prove in the face of newly implemented protocolised patient care approaches that also clearly improve patient outcome. However, individualised approach using GDT has been suggested to be superior to protocolised care and large meta-analyses still consistently show beneficial effects of GDT. Concerns of invasiveness were the reason why some patients' haemodynamics was not measured and in turn were not included in any GDT protocols. Recently, non-invasive devices to measure arterial blood pressure and haemodynamic variables emerged, and although they are very appealing and easy to use, they require further validation both by comparison to more invasive methods and by outcome trials.

show abstract

Variability in practice and factors predictive of total crystalloid administration during abdominal surgery: retrospective two-centre analysis

Abstract: Wide variability in crystalloid administration was observed both within and between individual anaesthesia providers, which might contribute to variability in surgical outcomes.

Cited by 128 publications

References 24 publications

Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety

Simplified Intraoperative Goal-Directed Therapy Using the FloTrac/Vigileo System: An Analysis of Its Usefulness and Safety

Impact of advanced monitoring variables on intraoperative clinical decision-making: an international survey

Current concepts in fluid therapy and non-invasive haemodynamic monitoring

Contact Info

Product

Resources

About