Goal-directed fluid therapy compared to liberal fluid therapy in patients subjected to colorectal surgery

Mostafa Elebieby, Mona Gad; Abdelkhalek, Mohamed; Eldadamony, Zenat Eldadamony Mohamed; Mohammed, Mohammed Nashaat

doi:TEJA-2023-0176

Goal-directed fluid therapy compared to liberal fluid therapy in patients subjected to colorectal surgery

Authors

TEJA-2023-0176

Abstract

Background
The best technique to manage intraoperative fluids during colorectal surgery has never been universally agreed upon. Key organ function is hampered by excessive intraoperative fluid administration: It lengthens and raises the expense of hospitalization by increasing the risk of heart failure that goes along with it, causing gastrointestinal membrane edema, and impeding the recovery of gastrointestinal functions.
Aim and objectives
Thestudy’s objective was to evaluate the impacts of goal-directed fluid therapy (GDFT) and liberal fluid therapy (LFT) using cardiometry in candidates with colorectal abnormalities.
Subjects and methods
100 patients were allocated into two equal groups in a random pattern for this prospective, randomized, controlled trial at the Mansoura oncology center; GDFT group) 50 patients): by using stroke volume optimization and the LFT group (50 patients): by using the traditional technique of fluid administration.
Results
Crystalloid and total fluids were significantly lower among GDFTgroup compared to LFT group. Both lactate and creatinine levels were slightly higher among the GDFT group than the LFT group but without a statistically significant difference. Postoperative complications were comparable between the studied groups.
Conclusions
However, GDFT needs lower total volume of fluids given to the patients it may not enhance patients’ postoperative outcomes after colorectal surgery compared to liberal fluid treatment. Moreover, both studied strategies did not affect organ perfusion, although serum lactate and serum creatinine were slightly higher with GDFT.

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