Impact of the FloTrac/VigileoTM Monitoring on Intraoperative Fluid Management and Outcome after Liver Resection

Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi

Research output: Contribution to journalArticle

Abstract

Backgrounds: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. Methods: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs. patients who did not (group B). We searched for differences about hemodynamics, fluid therapy and outcome. Results: Three hundred fifty-five patients underwent hepatic resection due to neoplasm: group A – n = 179 and group B – n = 176. At the end of the resection, patients of group A showed a higher mean arterial pressure (MAP) than group B (74 ± 12 vs. 49.4 ± 8 mm Hg, respectively; p < 0.001). Cardiac index and stroke volume variation in group A were within a normal range. Fluid input was higher in group B than in group A (12.0 ± 3.4 vs. 7.6 ± 3.1 mL/kg/h, respectively; p < 0.001) and fluid balance was significantly different: group A –400 ± 1,527 vs. group B 326 ± 1,527 mL (p < 0.001). Group B showed a greater number of cases complicated outcomes (36 vs. 20; p = 0.014). Considering only those subjects who were able to reach their hemodynamic targets (MAP ≥65 mm Hg and CVP ≤7 mm Hg), we found similar data. Conclusions: Patients who received a monitored fluid therapy experienced a safer outcome.

Original languageEnglish
JournalDigestive Surgery
DOIs
Publication statusAccepted/In press - Oct 26 2017

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Intraoperative Monitoring
Fluid Therapy
Hemodynamics
Liver
Central Venous Pressure
Arterial Pressure
Cardiac Volume
Water-Electrolyte Balance
Stroke Volume
Reference Values
Hemorrhage
Neoplasms

Keywords

  • Anaesthesia
  • Complications
  • Hepatobiliary surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Impact of the FloTrac/VigileoTM Monitoring on Intraoperative Fluid Management and Outcome after Liver Resection. / Giustiniano, Enrico; Procopio, Fabio; Ruggieri, Nadia; Grimaldi, Stefania; Torzilli, Guido; Raimondi, Ferdinando.

In: Digestive Surgery, 26.10.2017.

Research output: Contribution to journalArticle

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AU - Torzilli, Guido

AU - Raimondi, Ferdinando

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