Document Detail


Does central venous oxygen saturation-directed fluid therapy affect postoperative morbidity after colorectal surgery? A randomized assessor-blinded controlled trial.
MedLine Citation:
PMID:  20885291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The optimal amount and method for monitoring intravenous fluid in surgical patients is unresolved. Central venous oxygen saturation (Scvo2) has been used to guide therapy and predict outcome in high-risk and intensive-care patients. The aim of this prospective, randomized trial was to compare the rate of postoperative complications in patients receiving fluid therapy guided by Scvo2 and those treated with a traditional effluent fluid scheme. METHODS: Patients undergoing open colorectal and lower intestinal surgery (n = 241) were randomized to the Scvo2 group or the control group. The Scvo2 group received perioperatively crystalloid infusion 100 ml/h. When Scvo2 was less than 75%, a bolus of 3 ml/kg hydroxyethyl starch was given. The bolus was repeated if Scvo2 increased by 1 percentage point or more. The control group was maintained with crystalloid 800 ml/h and given extra fluid if there were clinical signs of hypovolemia. The participating surgeon, unaware of the group allocation, registered complications within day 30. RESULTS: Until 8:00 am on the first postoperative day, the Scvo2 group had received 3,869 ± 992 ml (mean ± SD) intravenous fluid compared with 6,491 ± 1,649 ml in the control group. Increase in weight was 0.8 ± 1.8 kg and 2.5 ± 1.6 kg in the two groups, respectively. The postoperative complication rate was 42% in both groups. CONCLUSION: Clinical outcomes among patients receiving Scvo2-guided perioperative fluid therapy were similar to those for patients treated with a traditional fluid regimen. Limitations in study design prevent full interpretation of these findings, and further large trials of this treatment algorithm are still required.
Authors:
Ib Jammer; Atle Ulvik; Christian Erichsen; Olav Lødemel; Gro Ostgaard
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  113     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1072-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. ib.jammer@helse-bergen.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Catheterization, Central Venous / adverse effects*,  methods
Colorectal Surgery / adverse effects*,  methods
Female
Fluid Therapy / adverse effects*,  methods
Humans
Male
Middle Aged
Morbidity
Oxygen Consumption / physiology*
Postoperative Complications / epidemiology*,  etiology,  prevention & control*
Prospective Studies
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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