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Lookup NU author(s): Sophie Noblett, Dr Christopher Snowden, Dr Brian Shenton, Alan Horgan
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Background: Protocolized fluid administration using oesophageal Doppler monitoring may improve the postoperative outcome in patients undergoing surgery. Methods: A total of 108 patients undergoing elective colorectal resection were recruited into a double-blind prospective randomized controlled trial. An oesophageal Doppler probe was placed in all patients. The control group received perioperative fluid at the discretion of the anaesthetist, whereas the intervention group received additional colloid boluses based on Doppler assessment. Primary outcome was length of postoperative hospital stay. Secondary outcomes were morbidity, return of gastrointestinal function and cytokine markers of the systemic inflammatory response. Standard preoperative and postoperative management was used in all patients. Results: Demographic and surgical details were similar in the two groups. Aortic flow time, stroke volume, cardiac output and cardiac index during the intraoperative period were higher in the intervention group (P < 0.050). The intervention group had a reduced postoperative hospital stay (7 versus 9 days in the control group; P = 0.005), fewer intermediate or major postoperative complications (2 versus 15 per cent; P = 0.043) and tolerated diet earlier (2 versus 4 days; P = 0.029). There was a reduced rise in perioperative level of the cytokine interleukin 6 in the intervention group (P = 0.039). Conclusion: A protocol-based fluid optimization programme using intraoperative oesophageal Doppler monitoring leads to a shorter hospital stay and decreased morbidity in patients undergoing elective colorectal resection. Copyright © 2006 British Journal of Surgery Society Ltd.
Author(s): Noblett, S.E., Snowden, C.P., Shenton, B.K., Horgan, A.
Publication type: Article
Publication status: Published
Journal: British Journal of Surgery
Year: 2006
Volume: 93
Issue: 9
Pages: 1069-1076
Print publication date: 01/09/2006
ISSN (print): 0007-1323
ISSN (electronic): 1365-2168
URL: http://dx.doi.org/10.1002/bjs.5454
DOI: 10.1002/bjs.5454
PubMed id: 16888706
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