A Prospective Comparison of TL-400 and NICOM for Goal-Directed Fluid Therapy in Gastrointestinal Tumors Surgery

Abstract Objective: Goal-directed fluid therapy (GDFT) based on NICOM(CheetahMedical, Vancouver, Washington) was highly associated with improved postoperative prognosis, but has several limitations. T-Line-400(TL-400, TensysMedical, San Diego, California) which is an emerging non-invasive hemodynamic monitor may be applicable for GDFT. Thus, the trial was to determine whether GDFT based on TL-400, when compared to GDFT based on NICOM, would lead to similar outcomes on patients undergoing gastrointestinal tumor resection.Methods: 100 patients who underwent laparoscopic resection of gastrointestinal tumors in Yongchuan Hospital of Chongqing Medical University from October 2020 to May 2021 were randomized into either TL-400 GDFT group (group T) or NICOM GDFT group (group N). The intraoperative fluid volume and the postoperative complications within 30 days were recorded.Results: There were no significantly statistical differences between groups with respect to the total fluid volume (2360 ±282ml vs 2295 ±223ml), the colloid volume (1167±153ml vs 1126±109ml), the crystalloid volume(1193 ±156ml vs 1173±157ml). Both GDFT based on TL-400 and NICOM strategies were equivalent for the first flatus(57.3±7.9 vs 58.5±8.5hours), wound healing time(11.2 ±1.2days vs 10.9±1.1days) and LOS(hospital length of stay) (13.3±1.4days vs 13.1±1.2days). In addition, the TL-400 had less data missing than the NICOM.Conclusion: TL-400 performs similarly to NICOM in guiding GDFT, with no significant differences in perioperative fluid infusion and postoperative prognosis in patients undergoing gastrointestinal tumor resection. Compared with NICOM, TL-400 can avoid the interference of electrocoagulation and can capture more data.Trial registration: This study has been registered on the Chinese Clinical Trial Registry (ChiCTR2100046350) (http://www.chictr.org.cn/index.aspx).

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Prospective comparison of the effects of intraoperative goal-directed fluid therapy and restrictive fluid therapy on complications in thoracoscopic lobectomy

Journal of International Medical Research ◽

10.1177/03000605211062787 ◽

2021 ◽

Vol 49 (12) ◽

pp. 030006052110627

Author(s):

Min Li ◽

Mingqing Peng

Keyword(s):

Postoperative Complications ◽

Fluid Therapy ◽

Therapy Group ◽

Pulmonary Complications ◽

Fluid Volume ◽

Postoperative Pulmonary Complications ◽

Clinical Trial Registry ◽

Thoracoscopic Lobectomy ◽

Prospective Comparison ◽

Goal Directed Fluid Therapy

Objective Restrictive fluid therapy is recommended in thoracoscopic lobectomy to reduce postoperative pulmonary complications, but it may contribute to hypovolemia. Goal-directed fluid therapy (GDFT) regulates fluid infusion to an amount required to avoid dehydration. We compared the effects of GDFT versus restrictive fluid therapy on postoperative complications after thoracoscopic lobectomy. Methods In total, 124 patients who underwent thoracoscopic lobectomy were randomized into the GDFT group (group G, n = 62) or restrictive fluid therapy group (group R, n = 62). The fluid volume and postoperative complications within 30 days of surgery were recorded. Results The total fluid volume in groups G and R was 1332 ± 364 and 1178 ± 278 mL, respectively. Group R received a smaller colloid fluid volume (523 ± 120 vs. 686 ± 180 mL), had a smaller urine output (448 ± 98 vs. 491 ± 101 mL), and received more norepinephrine (120 ± 66 vs. 4 ± 18 µg) than group G. However, there were no significant differences in postoperative pulmonary complications, acute kidney injury, length of hospital stay, or in-hospital mortality between the two groups. Conclusion Restrictive fluid therapy performs similarly to GDFT in thoracoscopic lobectomy but is a simpler fluid strategy than GDFT. Trial registration: This study has been registered at the Chinese Clinical Trial Registry (ChiCTR2100051339) ( http://www.chictr.org.cn/index.aspx ).

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