Hemodynamics, fluids & transfusion
Restrictive versus Decision Support Guided Fluid Therapy during Major Hepatic Resection Surgery: A Randomized Controlled Trial
Authors' conclusion
Patients managed using a clinical decision support system to guide fluid administration during major hepatic resection had a lower arterial lactate concentration at the end of surgery when compared to a more restrictive fluid strategy.
Study context
- Population
- Consecutive patients undergoing major liver surgery with an arterial catheter linked to an uncalibrated stroke volume monitorenrolled over 7 months
- Participants
- 90 patients
- Comparison
- Decision support guided fluid therapy vs restrictive fluid strategy
- Primary endpoint
- Arterial lactate level upon completion of surgery (skin closure)
- Follow-up
- End of surgery
Methodological detailstwo-arm, prospective, assessor- and patient-blinded, superiority
- Two-arm
- Prospective
- Assessor- and patient-blinded
- Superiority
Primary result
As reported in the abstract
Arterial lactate at completion of surgery · skin closure
Decision support
2.5
median · IQR 1.9–3.7 · mmol · l-1
Further findings
| Outcome | Decision support | P value |
|---|---|---|
| Blood loss (secondary exploratory)Decision support vs Restrictive · no difference | median 450 (quartile 1 to quartile 3 300–600) ml | P = 0.727 |
| Central venous pressure (secondary exploratory)Decision support vs Restrictive · higher in the decision support group | mean 7.7 (SD 2.0) mmHg | P < 0.002 |
- Blood loss (secondary exploratory): Restrictive median 500 (quartile 1 to quartile 3 300–800) ml
- Central venous pressure (secondary exploratory): Restrictive mean 6.6 (SD 1.1) mmHg
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Restrictive versus Decision Support Guided Fluid Therapy during Major Hepatic Resection Surgery: A Randomized Controlled Trial. Anesthesiology. Published 25 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →