Using Dynamic Variables to Guide Perioperative Fluid Management

Perel, Azriel

doi:10.1097/aln.0000000000003408

Cited by 24 publications

(16 citation statements)

References 51 publications

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“…Although our anesthesiology group, there has been an emphasis on goal-directed fluid management. Whereas, perioperative GDFT this consensus embraces a variety of strategies [ 30 ]. In any case, the study of an optimum therapy strategy in OC patients is an area with much work still to be done.…”

Section: Discussionmentioning

confidence: 99%

Postoperative pulmonary complications and outcomes in cytoreductive surgery for ovarian cancer: a propensity-matched analysis

Zhang

Gao

et al. 2022

BMC Anesthesiol

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Objectives To assess the prevalence of postoperative pulmonary complications (PPCs), the perioperative factors associated with PPCs, and the association of PPCs with postoperative outcomes in ovarian cancer patients undergoing cytoreductive surgery. Methods A retrospective analysis was conducted on patients who underwent cytoreductive surgery in our hospital, between September 2017 and January 2021, and patient medical records were reviewed to collect relevant clinical information. Univariable and multivariable analyses were used to identify significant risk factors for PPCs. Analysis of the association of PPCs with postoperative outcomes, mortality and 30-day readmission, was undertaken utilizing propensity score-matched controls and multivariable logistic regression model. Results Final analysis was performed with 268 ovarian cancer patients after cytoreductive surgery, among whom the incidence of PPCs was 26.9%, and the most frequent pulmonary complication was pleural effusion. According to the multivariate analysis, the intraoperative fluid infusion volume (L) (odds ratio (OR) 1.34; 95% confidence intervals (CI) 1.01–1.77; P = 0.040), diameter size of diaphragmatic resection (cm) (OR 1.16; 95% CI 1.06–1.28; P = 0.002), and surgical complexity scores (OR 1.26; 95% CI 1.13–1.42; P < 0.001) were significantly associated with the development of PPCs. The multivariable logistic regression analyses with propensity-matched controls demonstrated that the occurrence of PPCs significantly increased the risk of 30-day readmission (OR 6.01; 95% CI 1.12–32.40; P = 0.037) and did not significantly affect inpatient mortality. Conclusion Ovarian cancer patients undergoing cytoreductive surgery, especially those with diaphragmatic resection or higher surgical complexity scores, represent a high-risk population for PPCs. In addition, goal-directed fluid therapy is vital to reducing the occurrence of PPCs in patients at risk. PPCs were not associated with in-hospital mortality but were significantly associated with an increased risk of 30-day readmission after cytoreductive surgery.

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Section: Discussionmentioning

confidence: 99%

Postoperative pulmonary complications and outcomes in cytoreductive surgery for ovarian cancer: a propensity-matched analysis

Zhang

Gao

et al. 2022

BMC Anesthesiol

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“…< 8 mL kg -1 ) and neither PEEP nor driving pressure influences measurements [20,77]. However, other reviews and studies indicate that high TV ventila tion is required for accurate FR predictions [78][79][80][81]. When low TV ventilation is used, it has also been proposed to perform a tidal volume challenge.…”

Section: Dynamic Measurements Based On Heart-lung Interactionmentioning

confidence: 99%

Methods of assessing fluid responsiveness in septic shock patients: a narrative review

Weigl¹,

Adamski²,

Onichimowski³

et al. 2022

ait

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Septic shock, similar to other types of circulatory shock, is characterised by peripheral hypoperfusion and, consequently, inadequate tissue oxygen deli very. It is commonly believed that intravenous fluid infusion improves organ perfusion and reverses cel lular dysoxia. This belief might be valid in the early phase of septic shock, and some earlier studies [1] and international recommendations (Surviving Sepsis Campaign) [2] support this view. The physio logical rationale behind fluid bolus administration is that it causes intravascular volume expansion. According to the FrankStarling principle, increased left ventricular enddiastolic volume (i.e., preload) increases stroke volume (SV), resulting in improved organ perfusion. This mechanism works until the optimal preload is achieved. However, the patho physiology of septic shock is complex and compris es both distributive and cardiogenic components. At the peripheral level, the inflammatory process in sepsis damages the endothelial glycocalyx [3] and

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“…Zu den Limitationen gehören neben der Spontanatmung ein erhöhter intraabdomineller Druck, ein Tidalvolumen außerhalb von 8-10 ml/kgKG, eine rechtsventrikuläre Dysfunktion sowie Arrhythmien wie z. B. ein Vorhofflimmern [29]. Dadurch ist jedoch der sichere Einsatz dieser Variablen insbesondere im intensivmedizinischen Setting erheblich eingeschränkt.…”

Section: Pulsdruckvariation Und Schlagvolumenvariationunclassified

Hämodynamisches Monitoring auf der Intensivstation: Je invasiver, desto besser?

Renner¹,

Bein²,

Grünewald³

2022

Anästhesiol Intensivmed Notfallmed Schmerzther

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Die jüngsten Entwicklungen im Bereich minimalinvasiver und nichtinvasiver hämodynamischer Monitoringverfahren mögen deren Einsatz im operativen wie im intensivmedizinischen Bereich fördern. Diese Übersicht beurteilt den Stellenwert invasiver und weniger invasiver Monitoringverfahren und deren spezifische hämodynamische Variablen in der Anwendung bei kritisch kranken Patienten im intensivmedizinischen Bereich.

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Using Dynamic Variables to Guide Perioperative Fluid Management

Abstract: Dynamic variables that quantify the variations in the arterial pressure and plethysmographic waveforms during mechanical ventilation reflect fluid responsiveness. These variables may be helpful in identifying occult hypovolemia and in preventing unnecessary fluid administration.

Cited by 24 publications

References 51 publications

Postoperative pulmonary complications and outcomes in cytoreductive surgery for ovarian cancer: a propensity-matched analysis

Postoperative pulmonary complications and outcomes in cytoreductive surgery for ovarian cancer: a propensity-matched analysis

Methods of assessing fluid responsiveness in septic shock patients: a narrative review

Hämodynamisches Monitoring auf der Intensivstation: Je invasiver, desto besser?

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