TITLE

Flow-related techniques for preoperative goal-directed fluid optimization

AUTHOR(S)
M. Bundgaard-Nielsen; B. Ruhnau; N. H. Secher; H. Kehlet
PUB. DATE
January 2007
SOURCE
BJA: The British Journal of Anaesthesia;Jan2007, Vol. 98 Issue 1, p38
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background. Improved postoperative outcome has been demonstrated by perioperative maximization of cardiac stroke volume (SV) with fluid challenges, so-called goal-directed therapy. Oesophageal Doppler (OD) has been the most common technique for goal-directed therapy, but other flow-related techniques and parameters are available and they are potentially easier to apply in clinical practice. The objective of this investigation was therefore to use OD for preoperative SV maximization and compare the findings with a Modelflow determined SV, with an OD estimated corrected flow time (FTc), with central venous oxygenation ( $$S{\hbox{ v }}_{{\hbox{ O }}_{2}}$$ ) and with muscle and brain oxygenation assessed with near infrared spectroscopy (NIRS).Methods. Twelve patients scheduled for radical prostatectomy were anaesthetized before optimization of SV estimated by OD. A fluid challenge of 200 ml colloid was provided and repeated if at least a 10% increment in OD SV was obtained. Values were compared with simultaneously measured values of Modelflow SV, FTc, $$S{\hbox{ v }}_{{\hbox{ O }}_{2}}$$ and muscle and cerebral oxygenation estimated by NIRS.Results. Based upon OD assessment, optimization of SV was achieved after the administration of 400–800 ml (mean 483 ml) of colloid. The hypothetical volumes administered for optimization based upon Modelflow and $$S{\hbox{ v }}_{{\hbox{ O }}_{2}}$$ differed from OD in 10 and 11 patients, respectively. Changes in FTc and NIRS were inconsistent with OD guided optimization.Conclusion. Preoperative SV optimization guided by OD for goal-directed therapy is preferable compared with Modelflow SV, FTc, NIRS and $$S{\hbox{ v }}_{{\hbox{ O }}_{2}}$$ until outcome studies for the latter are available.
ACCESSION #
23431353

 

Related Articles

  • Optic Nerve Sheath Diameter Remains Constant during Robot Assisted Laparoscopic Radical Prostatectomy. Verdonck, Philip; Kalmar, Alain F.; Suy, Koen; Geeraerts, Thomas; Vercauteren, Marcel; Mottrie, Alex; De Wolf, Andre M.; Hendrickx, Jan F. A. // PLoS ONE;Nov2014, Vol. 9 Issue 11, p1 

    Background: During robot assisted laparoscopic radical prostatectomy (RALRP), a CO2 pneumoperitoneum (CO2PP) is applied and the patient is placed in a head-down position. Intracranial pressure (ICP) is expected to acutely increase under these conditions. A non-invasive method, the optic nerve...

  • Intermittent suppression as effective as continuous. Mulcahy, Nicholas // Urology Times;Sep2004, Vol. 32 Issue 13, p21 

    Reports on the data presented on the equivalent effect of intermittent androgen suppression with continuous androgen deprivation in patients with a prostate specific antigen (PSA) relapse after radical prostatectomy at the AUA annual meeting. Views of Ulf Tunn, director of the Urology Clinic,...

  • Is Neoadjuvant Hormonal Therapy before Radical Prostatectomy Indicated? Chun, Judy; Pruthi, Ray S. // Urologia Internationalis;May2004, Vol. 72 Issue 4, p275 

    Introduction: Despite the success of surgical monotherapy in treating patients with organ-confined disease, nearly half of all patients undergoing radical prostatectomy will be pathologically upstaged on evaluation of the operative specimen. One possible means of improving the proportion of...

  • Does caval aorta index correlate with central venous pressure in intravascular volume assessment in patients undergoing endoscopic transuretheral resection of prostate? EL-BARADEY G. F.; EL-SHMAA N. S. // Saudi Journal of Anaesthesia;Apr-Jun2016, Vol. 10 Issue 2, p174 

    Background and Objective: Ultrasonography has been suggested as a useful noninvasive tool for intravascular volume assessment in critically ill-patients. Fluid absorption is an inevitable complication of transurethral resection of the prostate (TURP). However, there are few data comparing the...

  • Hemodynamic changes during robotic radical prostatectomy. Vanlal Darlong; Kunhabdulla, Nishad Poolayullathil; Pandey, Ravindra; Punj, Jyotsna; Garg, Rakesh; Kumar, Rajeev // Saudi Journal of Anaesthesia;Jul2012, Vol. 6 Issue 3, p213 

    Background: Effect on hemodynamic changes and experience of robot-assisted laparoscopic radical prostatectomy (RALR P) in steep Trendelenburg position (45°) with high-pressure CO2 pneumoperitoneum is very limited. Therefore, we planned this prospective clinical trial to study the effect of...

  • Catheter Fragments Embolization. Monsuez, Jean-Jacques; Douard, Marie-Cécile; Martin-Bouyer, Yves // Angiology;Feb1997, Vol. 48 Issue 2, p117 

    Although the use of central venous silicone catheters is widespread, little is known about the incidence of catheter rupture and embolization. Over a three-year period, 3916 silicone catheters were inserted in 3672 patients in the authors' hospital. Catheter or catheter fragments embolism...

  • ROLE OF ANTIBIOTIC LINE LOCKS IN THE TREATMENT OF INFECTED CENTRAL VENOUS ACCESS DEVICES. Anoop, P.; Anjay, M. A. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jul2009, Vol. 94 Issue 7, p8 

    The article discusses the role of antibiotic line locks in treating a disease infected with central venous access devices. This medical case is portrayed by a girl on cyclical maintenance chemotherapy due to acute lymphoblastic leukaemia with neutropenic sepsis. The article also mentions the...

  • Complications associated with venous access devices: part one. Hamilton, Helen // Nursing Standard;3/8/2006, Vol. 20 Issue 26, p43 

    This article, the first of two, identifies the primary complications that can arise when inserting central venous access devices. The second part, to be published next week, examines secondary complications and preventive measures.

  • Cardiac Amyloidosis – A Devil in Disguise. Tønnessen, Theis // Cardiology;2019, Vol. 142 Issue 4, p250 

    The article focuses on a study related to the diagnosis and treatment of the cardiac amyloidosis. It mentions that magnetic resonance imaging (MRI) and echocardiography are helpful to obtain the right diagnosis, and nuclear imaging with bone tracers. It also mentions about treating cardiac...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics