The effect of goal-directed hemodynamic therapy on clinical outcomes in patients undergoing radical cystectomy: a randomized controlled trial

BMC Anesthesiology

Research

Min Hur¹  Jin-Tae Kim²  Hyun-Kyu Yoon²  Ja Hyeon Ku³  Dong Hyuk Kim⁴ 

[1] Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea;Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080, Seoul, Korea;Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080, Seoul, Korea;

关键词: Hemodynamic monitoring;    Goal-directed hemodynamic therapy;    Radical cystectomy;    Postoperative complications;   

DOI  :  10.1186/s12871-023-02285-9

 received in 2023-05-04, accepted in 2023-09-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis study investigated the effects of intraoperative goal-directed hemodynamic therapy (GDHT) on postoperative outcomes in patients undergoing open radical cystectomy.MethodsThis prospective, single-center, randomized controlled trial included 82 patients scheduled for open radical cystectomy between September 2018 and November 2021. The GDHT group (n = 39) received the stroke volume index- and cardiac index-based hemodynamic management using advanced hemodynamic monitoring, while the control group (n = 36) received the standard care under the discretion of attending anesthesiologists during surgery. The primary outcome was the incidence of a composite of in-hospital postoperative complications during hospital stays.ResultsA total of 75 patients were included in the final analysis. There was no significant difference in the incidence of in-hospital postoperative complications (28/39 [71.8%] vs. 30/36 [83.3%], risk difference [95% CI], -0.12 [-0.30 to 0.07], P = 0.359) between the groups. The amounts of intraoperative fluid administered were similar between the groups (2700 [2175–3250] vs. 2900 [1950–3700] ml, median difference [95% CI] -200 [-875 to 825], P = 0.714). The secondary outcomes, including the incidence of seven major postoperative complications, duration of hospital stay, duration of intensive care unit stay, and grade of complications, were comparable between the two groups. Trends in postoperative estimated glomerular filtration rate, serum creatinine, and C-reactive protein did not differ significantly between the two groups.ConclusionsIntraoperative GDHT did not reduce the incidence of postoperative in-hospital complications during the hospital stay in patients who underwent open radical cystectomy.Trial registrationThis study was registered at http://www.clinicaltrials.gov (Registration number: NCT03505112; date of registration: 23/04/2018).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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