TY - JOUR
T1 - Goal Directed Fluid Therapy Based on Stroke Volume Variation in Patients Undergoing Major Spine Surgery in the Prone Position
T2 - A Cohort Study
AU - Bacchin, Maria Renata
AU - Ceria, Chiara Marta
AU - Giannone, Sandra
AU - Ghisi, Daniela
AU - Stagni, Gaetano
AU - Greggi, Tiziana
AU - Bonarelli, Stefano
PY - 2016/4/1
Y1 - 2016/4/1
N2 - STUDY DESIGN.: Retrospective Observational study. OBJECTIVE.: To test whether a Goal Directed Fluid Therapy (GDFT) protocol, based on Stroke Volume Variation (SVV), applied in major spine surgery performed in the prone position, would be effective in reducing peri-operative red blood cells transfusions. SUMMARY OF BACKGROUND DATA.: Recent literature shows that optimizing perioperative fluid therapy is associated with lower complication rates and faster recovery. METHODS.: Data from 23 patients who underwent posterior spine arthrodesis surgery and whose intraoperative fluid administration was managed with the GDFT protocol were retrospectively collected and compared with data from 23 matched controls who underwent the same surgical procedure in the same timeframe, and who received a liberal intraoperative fluid therapy. RESULTS.: Patients in the GDFT group received less units of transfused Red Blood Cells (primary endpoint) in the intra (0 vs 2.0, p?=?0.0 4) and post-operative period (2.0 vs 4.0, p?=?0.003). They also received a lower amount of intraoperative crystalloids, had fewer blood losses and lower intraoperative peak lactate. In the postoperative period, patients in the GDFT group had fewer pulmonary complications and blood losses from surgical drains, needed less blood product transfusions, had a shorter Intensive Care Unit stay and a faster return of bowel function. We found no difference in the total length of stay among the two groups. CONCLUSION.: Our study shows that application of a Goal Directed Fluid Protocol based on Stroke Volume Variation in major spine surgery is feasible and can lead to reduced blood losses and transfusions, better post-operative respiratory performance, shorter ICU stay and faster return of bowel function.Level of Evidence: 3
AB - STUDY DESIGN.: Retrospective Observational study. OBJECTIVE.: To test whether a Goal Directed Fluid Therapy (GDFT) protocol, based on Stroke Volume Variation (SVV), applied in major spine surgery performed in the prone position, would be effective in reducing peri-operative red blood cells transfusions. SUMMARY OF BACKGROUND DATA.: Recent literature shows that optimizing perioperative fluid therapy is associated with lower complication rates and faster recovery. METHODS.: Data from 23 patients who underwent posterior spine arthrodesis surgery and whose intraoperative fluid administration was managed with the GDFT protocol were retrospectively collected and compared with data from 23 matched controls who underwent the same surgical procedure in the same timeframe, and who received a liberal intraoperative fluid therapy. RESULTS.: Patients in the GDFT group received less units of transfused Red Blood Cells (primary endpoint) in the intra (0 vs 2.0, p?=?0.0 4) and post-operative period (2.0 vs 4.0, p?=?0.003). They also received a lower amount of intraoperative crystalloids, had fewer blood losses and lower intraoperative peak lactate. In the postoperative period, patients in the GDFT group had fewer pulmonary complications and blood losses from surgical drains, needed less blood product transfusions, had a shorter Intensive Care Unit stay and a faster return of bowel function. We found no difference in the total length of stay among the two groups. CONCLUSION.: Our study shows that application of a Goal Directed Fluid Protocol based on Stroke Volume Variation in major spine surgery is feasible and can lead to reduced blood losses and transfusions, better post-operative respiratory performance, shorter ICU stay and faster return of bowel function.Level of Evidence: 3
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U2 - 10.1097/BRS.0000000000001601
DO - 10.1097/BRS.0000000000001601
M3 - Article
AN - SCOPUS:84962419392
SP - E1131-E1137
JO - Spine
JF - Spine
SN - 0362-2436
ER -