-
Something wrong with this record ?
Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement
J. Benes, L. Haidingerova, J. Pouska, J. Stepanik, A. Stenglova, J. Zatloukal, R. Pradl, I. Chytra, E. Kasal,
Language English Country England, Great Britain
Document type Journal Article, Observational Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
NLK
BioMedCentral
from 2001-01-12
BioMedCentral Open Access
from 2001
Directory of Open Access Journals
from 2001
Free Medical Journals
from 2001
PubMed Central
from 2001
Europe PubMed Central
from 2001
ProQuest Central
from 2009-01-01
Open Access Digital Library
from 2001-10-01
Open Access Digital Library
from 2001-01-01
Open Access Digital Library
from 2001-01-01
Health & Medicine (ProQuest)
from 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
from 2001
Springer Nature OA/Free Journals
from 2001-12-01
- MeSH
- Arterial Pressure physiology MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Arthroplasty, Replacement, Hip adverse effects methods MeSH
- Monitoring, Intraoperative adverse effects methods MeSH
- Postoperative Complications diagnosis etiology prevention & control MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Fluid Therapy methods MeSH
- Arthroplasty, Replacement, Knee adverse effects methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
BACKGROUND: The use of goal directed fluid protocols in intermediate risk patients undergoing hip or knee replacement was studied in few trials using invasive monitoring. For this reason we have implemented two different fluid management protocols, both based on a novel totally non-invasive arterial pressure monitoring device and compared them to the standard (no-protocol) treatment applied before the transition in our academic institution. METHODS: Three treatment groups were compared in this prospective study: the observational (CONTROL, N = 40) group before adoption of fluid protocols and two randomized groups after the transition to protocol fluid management with the use of the continuous non-invasive blood pressure monitoring (CNAP®) device. In the PRESSURE group (N = 40) standard variables were used for restrictive fluid therapy. Goal directed fluid therapy using pulse pressure variation was used in the GDFT arm (N = 40). The influence on the rate of postoperative complications, on the hospital length of stay and other parameters was assessed. RESULTS: Both protocols were associated with decreased fluid administration and maintained hemodynamic stability. Reduced rate of postoperative infection and organ complications (22 (55 %) vs. 33 (83 %) patients; p = 0.016; relative risk 0.67 (0.49-0.91)) was observed in the GDFT group compared to CONTROL. Lower number of patients receiving transfusion (4 (10 %) in GDFT vs. 17 (43 %) in CONTROL; p = 0.005) might contribute to this observation. No significant differences were observed in other end-points. CONCLUSION: In our study, the use of the fluid protocol based on pulse pressure variation assessed using continuous non-invasive arterial pressure measurement seems to be associated with a reduction in postoperative complications and transfusion needs as compared to standard no-protocol treatment. TRIAL REGISTRATION: ACTRN12612001014842.
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc16020216
- 003
- CZ-PrNML
- 005
- 20180605084616.0
- 007
- ta
- 008
- 160722s2015 enk f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1186/s12871-015-0131-8 $2 doi
- 024 7_
- $a 10.1186/s12871-015-0131-8 $2 doi
- 035 __
- $a (PubMed)26471495
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a enk
- 100 1_
- $a Benes, Jan $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic. benesj@fnplzen.cz.
- 245 10
- $a Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement / $c J. Benes, L. Haidingerova, J. Pouska, J. Stepanik, A. Stenglova, J. Zatloukal, R. Pradl, I. Chytra, E. Kasal,
- 520 9_
- $a BACKGROUND: The use of goal directed fluid protocols in intermediate risk patients undergoing hip or knee replacement was studied in few trials using invasive monitoring. For this reason we have implemented two different fluid management protocols, both based on a novel totally non-invasive arterial pressure monitoring device and compared them to the standard (no-protocol) treatment applied before the transition in our academic institution. METHODS: Three treatment groups were compared in this prospective study: the observational (CONTROL, N = 40) group before adoption of fluid protocols and two randomized groups after the transition to protocol fluid management with the use of the continuous non-invasive blood pressure monitoring (CNAP®) device. In the PRESSURE group (N = 40) standard variables were used for restrictive fluid therapy. Goal directed fluid therapy using pulse pressure variation was used in the GDFT arm (N = 40). The influence on the rate of postoperative complications, on the hospital length of stay and other parameters was assessed. RESULTS: Both protocols were associated with decreased fluid administration and maintained hemodynamic stability. Reduced rate of postoperative infection and organ complications (22 (55 %) vs. 33 (83 %) patients; p = 0.016; relative risk 0.67 (0.49-0.91)) was observed in the GDFT group compared to CONTROL. Lower number of patients receiving transfusion (4 (10 %) in GDFT vs. 17 (43 %) in CONTROL; p = 0.005) might contribute to this observation. No significant differences were observed in other end-points. CONCLUSION: In our study, the use of the fluid protocol based on pulse pressure variation assessed using continuous non-invasive arterial pressure measurement seems to be associated with a reduction in postoperative complications and transfusion needs as compared to standard no-protocol treatment. TRIAL REGISTRATION: ACTRN12612001014842.
- 650 _2
- $a dospělí $7 D000328
- 650 _2
- $a senioři $7 D000368
- 650 _2
- $a senioři nad 80 let $7 D000369
- 650 _2
- $a arteriální tlak $x fyziologie $7 D062186
- 650 _2
- $a náhrada kyčelního kloubu $x škodlivé účinky $x metody $7 D019644
- 650 _2
- $a totální endoprotéza kolene $x škodlivé účinky $x metody $7 D019645
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a tekutinová terapie $x metody $7 D005440
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a peroperační monitorování $x škodlivé účinky $x metody $7 D016343
- 650 _2
- $a pooperační komplikace $x diagnóza $x etiologie $x prevence a kontrola $7 D011183
- 650 _2
- $a prospektivní studie $7 D011446
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a pozorovací studie $7 D064888
- 655 _2
- $a randomizované kontrolované studie $7 D016449
- 655 _2
- $a práce podpořená grantem $7 D013485
- 700 1_
- $a Haidingerová, Lenka $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic. $7 xx0224968
- 700 1_
- $a Pouska, Jiri $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Stepanik, Jan $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Stenglova, Alena $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Zatloukal, Jan $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Pradl, Richard $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Chytra, Ivan $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 700 1_
- $a Kasal, Eduard $u Department of Anesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, alej Svobody 80, 306 40, Plzen, Czech Republic.
- 773 0_
- $w MED00006769 $t BMC anesthesiology $x 1471-2253 $g Roč. 15, č. - (2015), s. 148
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/26471495 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20160722 $b ABA008
- 991 __
- $a 20180605084818 $b ABA008
- 999 __
- $a ok $b bmc $g 1154886 $s 944744
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2015 $b 15 $c - $d 148 $e 20151015 $i 1471-2253 $m BMC anesthesiology $n BMC Anesthesiol $x MED00006769
- LZP __
- $a Pubmed-20160722
