Effect of intraoperative transesophageal Doppler-guided fluid therapy versus central venous pressure-guided fluid therapy on renal allograft outcome in patients undergoing living donor renal transplant surgery: a comparative study
| العنوان: | Effect of intraoperative transesophageal Doppler-guided fluid therapy versus central venous pressure-guided fluid therapy on renal allograft outcome in patients undergoing living donor renal transplant surgery: a comparative study |
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| المؤلفون: | Tanmay Tiwari, Pratibha Singh, Sandeep Sahu, Sanjay Kumar, Divya Srivastava, Abhilash Chandra |
| المصدر: | Journal of Anesthesia. 29:842-849 |
| بيانات النشر: | Springer Science and Business Media LLC, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Central Venous Pressure, Living donor, Postoperative Complications, Anesthesiology, Living Donors, Intravascular volume status, Humans, Medicine, Arterial Pressure, Prospective Studies, Central line, business.industry, Central venous pressure, Stroke Volume, Stroke volume, Middle Aged, Kidney Transplantation, Echocardiography, Doppler, Surgery, Anesthesiology and Pain Medicine, Renal transplant, Anesthesia, Renal allograft, Fluid Therapy, Kidney Failure, Chronic, Female, business, Echocardiography, Transesophageal |
| الوصف: | Transesophageal Doppler (TED)-guided intraoperative fluid therapy has shown to noninvasively optimize intravascular volume and reduce postoperative morbidity. The aim of this study was to compare the effects of Doppler-guided intraoperative fluid administration and central venous pressure (CVP)-guided fluid therapy on renal allograft outcome and postoperative complications. A prospective nonrandomized active controlled study was conducted on end-stage renal disease patients scheduled for living donor renal transplant surgery. 110 patients received intraoperative fluid guided by corrected flow time (FTc) and variation in stroke volume values obtained by continuous TED monitoring. Data of 104 patients in whom intraoperative fluid administration was guided by CVP values were retrospectively obtained for a control. The amount of intraoperative fluid given in the study group (12.20 ± 4.24 ml/kg/h) was significantly lower than in the controls (22.21 ± 4.67 ml/kg/h). The amount of colloid used was also significantly less and fewer recipients were seen to require colloid (69 vs 85 %). The mean arterial pressures were comparable throughout. CVP reached was 7.18 ± 3.17 mmHg in the study group. It was significantly higher in the controls (13.42 ± 3.12 mmHg). The postoperative graft function and rate of dysfunction were comparable. Side-effects like postoperative dyspnoea (4.8 vs 0 %) and tissue edema (9.6 vs 2.7 %) were higher in the controls. FTc-guided intraoperative fluid therapy achieved the same rate of immediate graft function as CVP–guided fluid therapy but used a significantly less amount of fluid. The incidence of postoperative complications related to fluid overload was also reduced. The use of TED may replace invasive central line insertions in the future. |
| تدمد: | 1438-8359 0913-8668 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::987143caec04cf843b540eb06729b878Test https://doi.org/10.1007/s00540-015-2046-4Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....987143caec04cf843b540eb06729b878 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14388359 09138668 |
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