Key result
Goal-directed fluid therapy guided by stroke volume variation optimization achieved similar intraoperative haemodynamic stability as stroke volume optimization but significantly reduced postoperative complications and intensive care unit stay.
Why the study?
The study aimed to compare stroke volume versus stroke volume variations as guidance for fluid management using electrical cardiometry during major abdominal surgeries.
Does intraoperative fluid administration managed by stroke volume optimization improve haemodynamic changes compared to stroke volume variation optimization in patients scheduled for major abdominal surgery?
RCT (n=60)
Closed envelope process
No
Does intraoperative fluid administration managed by stroke volume optimization improve haemodynamic changes compared to stroke volume variation optimization in patients scheduled for major abdominal surgery?
Fluid therapy guided by stroke volume variation optimization avoids the postoperative pulmonary edema associated with stroke volume optimization during major abdominal surgery, while achieving similar haemodynamic stability.
Background: The aim of the present study was for comparison of stroke volume versus stroke volume variations as guidance for fluid management under guide directions of electrical cardiometry, during major abdominal surgeries. The primary outcome was to compare between two fluid infusion protocols, regarding the haemodynamic changes, whereas secondary outcomes were to evaluate the impact of each protocol on extravascular lung water and oxygenation changes in the post-operative periods, study the effect of each of the adopted method on postoperative complications, incidence of acute kidney injury and intensive care unit staying duration. Settings and Design: This study was a prospective randomized controlled clinical trial. Methods: The study was carried out on 60 patients scheduled for major abdominal surgery. 30 patients, whose intraoperative fluid administration was managed by stroke volume optimization, were compared with 30 patients who received intraoperative fluid therapy guided by stroke volume variation optimization. Results: There was no difference regarding haemodynamic changes in terms of mean heart rate, mean blood pressure, stroke volume, stroke volume variation, and cardiac index. The first group showed a significant incidence of postoperative pulmonary edema which affected oxygentation process till 24 hours postoperatively.
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Aly et al. (2022) conducted an RCT in Major abdominal surgery (n=60). Stroke volume variation (SVV) optimization vs. Stroke volume (SV) optimization was evaluated on Intraoperative haemodynamic changes (mean heart rate, mean blood pressure, stroke volume, stroke volume variation, and cardiac index). Goal-directed fluid therapy guided by stroke volume variation optimization achieved similar intraoperative haemodynamic stability as stroke volume optimization but significantly reduced postoperative complications and intensive care unit stay.
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