Hemodynamics, fluids & transfusion
Assisted Fluid Management and Sublingual Microvascular Flow During High-Risk Abdominal Surgery: A Randomized Controlled Trial
Primary resultResult — go to the resultMedian difference 0.30 95% CI 0.19–0.49Authors' conclusion
Use of an AFM-guided GDFT strategy resulted in higher sublingual microvascular flow during surgery compared to use of a standard GDFT strategy.
Study context
- Population
- Consecutive patients undergoing high-risk abdominal surgery requiring an arterial catheter and uncalibrated stroke volume (SV) monitoring
- Participants
- 86 patients
- Comparison
- Assisted fluid management (AFM)-guided goal-directed fluid therapy (GDFT) vs standard GDFT
- Primary endpoint
- Average intraoperative microvascular flow index (MFI) across 4 intraoperative time points
Methodological detailsbicenter, parallel, 2-arm, prospective, patient and assessor-blinded, superiority
- Bicenter
- Parallel
- 2-arm
- Prospective
- Patient and assessor-blinded
- Superiority
Primary result
As reported in the abstract
Median difference
0.30
95% CI 0.19–0.49
P < 0.001
By group
AFM
2.89
median · IQR 2.84–2.94
Standard GDFT
2.59
median · IQR 2.38–2.78 · points
AFM vs Standard GDFT
median difference 0.30 (95% CI 0.19–0.49); P < 0.001
Secondary outcomes
Cardiac index
P = 0.001
SVI
P = 0.018
Arterial lactate · end of surgery
P = 0.026
Fluid volume and norepinephrine
- AFM received a higher fluid volume but 3 times less norepinephrine than standard GDFT
- P < 0.001
Original publication
Assisted Fluid Management and Sublingual Microvascular Flow During High-Risk Abdominal Surgery: A Randomized Controlled Trial. Anesth Analg. Published 1 May 2025. doi:10.
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