دورية أكاديمية
Goal-directed fluid therapy vs. low central venous pressure during major open liver resections (GALILEO): a surgeon- and patient-blinded randomized controlled trial.
| العنوان: | Goal-directed fluid therapy vs. low central venous pressure during major open liver resections (GALILEO): a surgeon- and patient-blinded randomized controlled trial. |
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| المؤلفون: | Jongerius IM; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., Mungroop TH; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: t.h.mungroop@amsterdamumc.nl., Uz Z; Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands., Geerts BF; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., Immink RV; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., Rutten MVH; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., Hollmann MW; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands., van Gulik TM; Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands., Besselink MG; Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands., Veelo DP; Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: d.p.veelo@amsterdamumc.nl. |
| المصدر: | HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2021 Oct; Vol. 23 (10), pp. 1578-1585. Date of Electronic Publication: 2021 Apr 12. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 100900921 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-2574 (Electronic) Linking ISSN: 1365182X NLM ISO Abbreviation: HPB (Oxford) Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : Oxford, UK : Elsevier Original Publication: 1999-2001: Oxford, England : ISIS Medical Media |
| مواضيع طبية MeSH: | Goals* , Surgeons*, Central Venous Pressure ; Fluid Therapy ; Humans ; Liver |
| مستخلص: | Background: Low central venous pressure (low-CVP) is the clinical standard for fluid therapy during major liver surgery. Although goal-directed fluid therapy (GDFT) has been associated with reduced morbidity and mortality in major abdominal surgery, concerns remain on blood loss when applying GDFT in liver surgery. This randomized trial compared outcomes of low-CVP and GDFT during major liver resections. Methods: In this surgeon- and patient-blinded RCT, patients undergoing major open liver resections (≥3 segments) were randomized between low-CVP (n = 20) or GDFT (n = 20). Primary outcome was intraoperative blood loss. Secondary outcomes included the quality of the surgical field (VAS scale 0 (worst)-100 (best)) and major morbidity (≥grade 3 Clavien-Dindo). Results: During surgery, CVP was 3 ± 2 mmHg in the low-CVP group vs. 7 ± 3 mmHg in the GDFT group (P < 0.001). Blood loss (1425 vs. 1275 mL; P = 0.640) and the rate of major morbidity (40% vs. 50%, P = 0.751), did not differ between low-CVP and GDFT, respectively. The quality of the surgical field was comparable between groups (low-CVP 83% vs. GDFT 80%, P = 0.955). Conclusion: In major open liver resections, GDFT was not associated with differences in intraoperative blood loss, major morbidity or quality of the surgical field, compared to low-CVP. Larger RCTs are needed to confirm this finding. Registration number: NTR5821 (www.trialregister.nl). (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| سلسلة جزيئية: | NTR NTR5821 |
| تواريخ الأحداث: | Date Created: 20210518 Date Completed: 20220126 Latest Revision: 20220126 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.hpb.2021.03.013 |
| PMID: | 34001451 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1477-2574 |
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| DOI: | 10.1016/j.hpb.2021.03.013 |