-
Je něco špatně v tomto záznamu ?
Multi-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial
P. Szturz, P. Folwarczny, R. Kula, J. Neiser, P. Ševčík, J. Benes,
Jazyk angličtina Země Itálie
Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem
- MeSH
- chirurgie trávicího traktu metody MeSH
- EGDT MeSH
- hemodynamika * MeSH
- hodnocení rizik MeSH
- lidé středního věku MeSH
- lidé MeSH
- pooperační komplikace prevence a kontrola MeSH
- prospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopressors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi-parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery. METHODS: Intermediate-to-high risk patients undergoing gastrointestinal surgery were randomized to standard care (control) or multi-parametric pGDT (intervention). Postoperative complications and death rate as well as hospital length of stay were assessed as primary and secondary outcomes. RESULTS: Overall, 140 patients (intervention, N.=71, and control, N.=69) were included and randomized out of 197 eligible. Higher vasoactive/inotropic drug use and lower fluid balance were observed in the intervention group leading to favorable hemodynamic profile. The pGDT intervention was associated with improved primary outcome (28 days mortality and morbidity defined as occurrence of any defined complication) - 20 patients (28.2%) versus 32 (46.4%) in the control group (P=0.036); RR 0.61 (95% CI: 0.39-0.95), P=0.03. No differences in mortality and hospital length of stay were observed between groups. CONCLUSIONS: In this monocentric trial the multi-parametric pGDT protocol based on domain specific functional hemodynamic parameters was associated with lower rate of postoperative complications in intermediate-to-high risk patients undergoing scheduled gastrointestinal procedures.
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc20022878
- 003
- CZ-PrNML
- 005
- 20201214124926.0
- 007
- ta
- 008
- 201125s2019 it f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.23736/S0375-9393.18.12467-9 $2 doi
- 035 __
- $a (PubMed)29756693
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a it
- 100 1_
- $a Szturz, Pavel $u Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava, Czech Republic. Department of Intensive Care Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
- 245 10
- $a Multi-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial / $c P. Szturz, P. Folwarczny, R. Kula, J. Neiser, P. Ševčík, J. Benes,
- 520 9_
- $a BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopressors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi-parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery. METHODS: Intermediate-to-high risk patients undergoing gastrointestinal surgery were randomized to standard care (control) or multi-parametric pGDT (intervention). Postoperative complications and death rate as well as hospital length of stay were assessed as primary and secondary outcomes. RESULTS: Overall, 140 patients (intervention, N.=71, and control, N.=69) were included and randomized out of 197 eligible. Higher vasoactive/inotropic drug use and lower fluid balance were observed in the intervention group leading to favorable hemodynamic profile. The pGDT intervention was associated with improved primary outcome (28 days mortality and morbidity defined as occurrence of any defined complication) - 20 patients (28.2%) versus 32 (46.4%) in the control group (P=0.036); RR 0.61 (95% CI: 0.39-0.95), P=0.03. No differences in mortality and hospital length of stay were observed between groups. CONCLUSIONS: In this monocentric trial the multi-parametric pGDT protocol based on domain specific functional hemodynamic parameters was associated with lower rate of postoperative complications in intermediate-to-high risk patients undergoing scheduled gastrointestinal procedures.
- 650 _2
- $a senioři $7 D000368
- 650 _2
- $a chirurgie trávicího traktu $x metody $7 D013505
- 650 _2
- $a EGDT $7 D000074388
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 12
- $a hemodynamika $7 D006439
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a pooperační komplikace $x prevence a kontrola $7 D011183
- 650 _2
- $a prospektivní studie $7 D011446
- 650 _2
- $a hodnocení rizik $7 D018570
- 650 _2
- $a výsledek terapie $7 D016896
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a randomizované kontrolované studie $7 D016449
- 655 _2
- $a práce podpořená grantem $7 D013485
- 700 1_
- $a Folwarczny, Pavel $u Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Kula, Roman $u Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Neiser, Jan $u Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava, Czech Republic. Department of Intensive Care Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Ševčík, Pavel $u Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava, Czech Republic. Department of Intensive Care Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
- 700 1_
- $a Benes, Jan $u Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic - benesj@fnplzen.cz.
- 773 0_
- $w MED00003363 $t Minerva anestesiologica $x 1827-1596 $g Roč. 85, č. 3 (2019), s. 244-254
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/29756693 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20201125 $b ABA008
- 991 __
- $a 20201214124926 $b ABA008
- 999 __
- $a ok $b bmc $g 1595197 $s 1113554
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2019 $b 85 $c 3 $d 244-254 $e 20180511 $i 1827-1596 $m Minerva anestesiologica $n Minerva Anestesiol $x MED00003363
- LZP __
- $a Pubmed-20201125
