Fluid Therapy during Anaesthesia: Comparison of Standard and Extensive Method of HaemodynamicMonitoring

Overview

Objective:
Impact of two different types of haemodynamic monitoring (transesophageal doppler/routine) on fluid therapymanagement during general anaesthesia and early postoperative course in high risk surgical patients.Design: Prospective, comparative study in one centre.Setting: University Hospital Prague-Motol.Material and Method: 50 patients (ASA ≥ III)who underwent surgery under general anaesthesia admitted to ICU were enrolledin the study. 25 patients were routinely monitored,transesophageal doppler was used and fluid therapy guidance was basedon its results in 25 patients.Results: The tested group comprised of 13 men, 12 women (61.8 ± 11.4 years). The control group comprised 20 men and 5women (53.3 ± 17.2 years).We found significant differences at the age of patients.We did not found significant differencesin circulatory peroperative parametres between groups. Mean fluid balance between time T0 and T2 was 2501 ± 1440 ml intested group, 2930 ± 1847 ml in controlled group (n. s).We found significant increase of cardiac index from the beginningto the end of operation in tested group. (CI T0 2.74 ± 1.11 L/min/m2 , CIT2 3.65 ± 1.06 L/min/m2, P < 0.001). We did not findsignificant difference in APACHE II and SOFA scoring on the 1st and the 3rd day after operation. The mean length of stay inICU was not different between groups. One patient of the study group died and four patients died in the control group. Nosignificant difference in mortality was found.Conlusions: No difference in fluid management during operation and early postoperative organ dysfunction was observed.

Key words:
transesophageal doppler – general anaesthesia – scoring systems – postoperative course