Goal-directed Fluid Therapy Versus Conventional Fluid Therapy During Craniotomy and Clipping of Cerebral Aneurysm: A Prospective Randomized Controlled Trial
| Autor: | Hemant Bhagat, Banashree Mandal, Shalvi Mahajan, Ankur Luthra, Rajeev Chauhan, Navneet Singla, Sanket Agrawal, Summit Dev Bloria, Narender Kaloria, Shamik Kr Paul, Nidhi Panda, Shiv Lal Soni, Shailesh Gupta, Ketan Kataria, Kiran Jangra |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Subarachnoid hemorrhage business.industry Glasgow Outcome Scale medicine.medical_treatment Central venous pressure Vasospasm Intracranial Aneurysm Clipping (medicine) Subarachnoid Hemorrhage medicine.disease Anesthesiology and Pain Medicine Aneurysm Blood pressure Modified Rankin Scale Anesthesia medicine Fluid Therapy Humans Surgery Neurology (clinical) Prospective Studies business Goals Craniotomy |
| Zdroj: | Journal of neurosurgical anesthesiology. 34(4) |
| ISSN: | 1537-1921 |
| Popis: | BACKGROUND Fluid imbalance is common after aneurysmal subarachnoid hemorrhage and negatively impacts clinical outcomes. We compared intraoperative goal-directed fluid therapy (GDFT) using left ventricular outflow tract velocity time integral (LVOT-VTI) measured by transesophageal echocardiography with central venous pressure (CVP)-guided fluid therapy during aneurysm clipping in aneurysmal subarachnoid hemorrhage patients. METHODS Fifty adults scheduled for urgent craniotomy for aneurysm clipping were randomly allocated to 2 groups: group G (n=25) received GDFT guided by LVOT-VTI and group C (n=25) received CVP-guided fluid management. The primary outcome was intraoperative mean arterial pressure (MAP). Secondary outcomes included volume of fluid administered and several other intraoperative and postoperative variables, including neurological outcome at hospital discharge and at 30 and 90 days. RESULTS There was no difference in MAP between the 2 groups despite patients in group G receiving lower volumes of fluid compared with patients in group C (2503.6±534.3 vs. 3732.8±676.5 mL, respectively; P |
| Databáze: | OpenAIRE |
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