Faculty Opinions recommendation of Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery.

2017 ◽  
Author(s):  
Michael James
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Closed Loop ◽  
Controlled Trial ◽  
Loop System ◽  
Major Abdominal Surgery ◽  
Closed Loop System ◽  
System A ◽  
Goal Directed Fluid Therapy ◽  
Double Blinded

scholarly journals Implementation of closed-loop-assisted intra-operative goal-directed fluid therapy during major abdominal surgery

2018 ◽  
Vol 35 (9) ◽  
pp. 650-658 ◽  
Author(s):  
Alexandre Joosten ◽  
Sean Coeckelenbergh ◽  
Amelie Delaporte ◽  
Brigitte Ickx ◽  
Jean Closset ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Closed Loop ◽  
Major Abdominal Surgery ◽  
Goal Directed Fluid Therapy

scholarly journals Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System

2018 ◽  
Vol 128 (1) ◽  
pp. 55-66 ◽  
Author(s):  
Alexandre Joosten ◽  
Amelie Delaporte ◽  
Brigitte Ickx ◽  
Karim Touihri ◽  
Ida Stany ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Stroke Volume ◽  
Fluid Balance ◽  
Fluid Therapy ◽  
Closed Loop ◽  
Loop System ◽  
Closed Loop System ◽  
Operative Morbidity ◽  
Goal Directed Fluid Therapy ◽  
Balanced Crystalloid

Abstract Background The type of fluid and volume regimen given intraoperatively both can impact patient outcome after major surgery. This two-arm, parallel, randomized controlled, double-blind, bi-center superiority study tested the hypothesis that when using closed-loop assisted goal-directed fluid therapy, balanced colloids are associated with fewer postoperative complications compared to balanced crystalloids in patients having major elective abdominal surgery. Methods One hundred and sixty patients were enrolled in the protocol. All patients had maintenance-balanced crystalloid administration of 3 ml · kg–1 · h–1. A closed-loop system delivered additional 100-ml fluid boluses (patients were randomized to receive either a balanced-crystalloid or colloid solution) according to a predefined goal-directed strategy, using a stroke volume and stroke volume variation monitor. All patients were included in the analysis. The primary outcome was the Post-Operative Morbidity Survey score, a nine-domain scale, at day 2 postsurgery. Secondary outcomes included all postoperative complications. Results Patients randomized in the colloid group had a lower Post-Operative Morbidity Survey score (median [interquartile range] of 2 [1 to 3] vs. 3 [1 to 4], difference –1 [95% CI, –1 to 0]; P < 0.001) and a lower incidence of postoperative complications. Total volume of fluid administered intraoperatively and net fluid balance were significantly lower in the colloid group. Conclusions Under our study conditions, a colloid-based goal-directed fluid therapy was associated with fewer postoperative complications than a crystalloid one. This beneficial effect may be related to a lower intraoperative fluid balance when a balanced colloid was used. However, given the study design, the mechanism for the difference cannot be determined with certainty.

Overnight automated type 1 diabetes control under MD-logic closed-loop system: a randomized crossover trial

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Revital Nimri ◽  
Thomas Danne ◽  
Olga Kordonouri ◽  
Eran Atlas ◽  
Natasa Bratina ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Crossover Trial ◽  
Loop System ◽  
Diabetes Control ◽  
Closed Loop System ◽  
System A ◽  
Randomized Crossover Trial

scholarly journals The Impact of Goal-Directed Fluid Therapy in Prolonged Major Abdominal Surgery on Extravascular Lung Water and Oxygenation: A Randomized Controlled Trial

2019 ◽  
Vol 7 (8) ◽  
pp. 1276-1281
Author(s):  
Ahmed Hasanin ◽  
Karim Hussein Mourad ◽  
Inas Farouk ◽  
Sherin Refaat ◽  
Ahmed Nabih ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Extravascular Lung Water ◽  
Stroke Volume Variation ◽  
Major Abdominal Surgery ◽  
Control Group ◽  
Lung Water ◽  
Goal Directed Fluid Therapy ◽  
Ultrasound Score ◽  
The Impact

BACKGROUND: A growing interest had been paid to goal-directed fluid therapy (GDT) in abdominal surgery; however, its impact on the respiratory profile was not well investigated. AIM: We evaluated the impact of GDT on postoperative extravascular lung water and oxygenation after prolonged major abdominal surgery. METHODS: A randomised, controlled study was conducted in Kasr Alainy hospital from April 2016 till December 2017 including 120 adult patients scheduled for prolonged major abdominal surgery. Patients were randomised into either GDT group (n = 60) who received baseline restricted fluid therapy (2 mL/Kg/hour) which is guided by stroke volume variation, or control group (n = 60) who received standard care. Both study groups were compared according to hemodynamic data, fluid requirements, lung ultrasound score, and PaO2/fraction of inspired oxygen ratio (P/F ratio), RESULTS: Intraoperatively, GDT group received less volume of fluids and showed higher intraoperative mean arterial pressure compared to the control group. Postoperatively, lung ultrasound score was lower, and P/F ratio was higher in the GDT group compared to the control group. The number of patients who showed a significant postoperative increase in LUS was higher in the control group 44 (73%) patients versus 14 (23%) patients, P < 0.001). CONCLUSIONS: Using stroke volume variation for guiding fluid therapy in prolonged, major abdominal operations were associated with better hemodynamic profile, less intraoperative fluid administration, lower extravascular lung water and better oxygenation compared to standard care.

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