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Comparison of Goal-Directed Fluid Therapy Using LiDCOrapid System with Regular Fluid Therapy in Patients Undergoing Spine Surgery as a Randomised Clinical Trial

Reza Shariat Moharari
Reza Shariat Moharari
, 
Shervin Shahinpour
Shervin Shahinpour
, 
Farhad Etezadi
Farhad Etezadi
, 
Atabak Najafi
Atabak Najafi
, 
Mohammad Reza Khajavi
Mohammad Reza Khajavi
 and 
Pejman Pourfakhr
Pejman Pourfakhr
   | Sep 25, 2022
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Article Category: Original Article
Published Online: Sep 25, 2022
Page range: 1 - 9
DOI: https://doi.org/10.2478/rjaic-2021-0001
Keywords
© 2021 Reza Shariat Moharari et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

CONSORT flow diagram showing the flow of patients through each stage of study.
CONSORT flow diagram showing the flow of patients through each stage of study.

Figure 2

Intraoperative protocol of GDFT in LiDCO group. SVV, stroke volume variation; CO, cardiac output; CI, cardiac index; SV, stroke volume. *If volume loss due to bleeding reaches maximum allowable blood loss (MABL) fluid challange will be stopped and fluid therabhy will be continued with blood transfusion.
Intraoperative protocol of GDFT in LiDCO group. SVV, stroke volume variation; CO, cardiac output; CI, cardiac index; SV, stroke volume. *If volume loss due to bleeding reaches maximum allowable blood loss (MABL) fluid challange will be stopped and fluid therabhy will be continued with blood transfusion.

Figure 3

Base deficit (meq/l) values in two groups.
Base deficit (meq/l) values in two groups.

Figure 4

Comparison of injected crystalloid volume urinary and output in two groups.
Comparison of injected crystalloid volume urinary and output in two groups.

Comparison of peri- and postsurgical complications in two groups of patients

Group Control N (%) LiDCO-Rapid N (%) Total N (%) Probability
Blood transfusion 2 (10) 3 (15) 5 (12.5) 0.633
Myocardial infarction 0 (0) 0(0) 0 (0) -
Stroke 0 (0) 0 (0) 0 (0) -
Pulmonary thromboembolism 0 (0) 0(0) 0 (0) -
Deep vein thrombosis 1 (5) 0(0) 1 (2.5) 0.3
Pneumonia 1 (5) 1(5) 2 (5) 0.100
Pulmonary edema 0 (0) 0 (0) 0 (0) -
Urinary tract infection 0 (0) 0(0) 0 (0) 0.1000
Sepsis 0 (0) 0 (0) 0 (0) -
Acute respiratory distress syndrome 0 (0) 0 (0) 0 (0) -
Acute renal failure 0 (0) 0 (0) 0 (0) -
Postsurgical nausea and vomiting 6 (30) 3 (15) 9 (22.5) 0.256
Reintubation 0 (0) 0 (0) 0 (0) -
Lower extremity nerve defect 0 (0) 0 (0) 0 (0) -
Total complications 11 (55) 6 (30) 17 (42.5) 0.110

Comparing the peri- and postsurgical quantitative variables in two groups

Group N Mean Standard deviation Median IQR Probability
Bleeding (cc) control 20 527.00 273.90 - - 0.916
LiDCO 20 517.50 290.47 - -
Base excess (mEq/L) control 20 −8.25 1.94 - - <0.001
LiDCO 20 −4.75 2.22 - -
Volume (cc) crystalloid control 20 1920.00 584.53 - - 0.001
LiDCO 20 1332.50 409.19 - -
Urine output (cc) control 20 647.50 211.18 - - <0.001
LiDCO 20 377.50 105.72 - -
Hospitalization (day) control 20 - - 2 2–3 0.027*
LiDCO 20 - - 2 1–2
ICU admission (day) control 10 - - 0.5 0–1 0.087*
LiDCO 6 - - 0 0–0.75
Starting solids (hour) control 20 - - 10 8–12 <0.001*
LiDCO 20 - - 7 6–7.5

Preoperative characteristics of patients divided into two groups

Group Control N (%) LiDCO-Rapid N (%) Total N (%) Probability
Sex Female 11 (55) 11(55) 22 (55) 0.624
Male 9 (45) 9 (45) 18 (45)
ASA I 5 (25) 6 (30) 11 (27.5) 0.500
II 15 (75) 14 (70) 29 (72.5)
Hypertension 10 (50) 6 (30) 16 (40) 0.167
Hyperlipidemia 2 (10) 0 (0) 2 (5) 0.244
Diabetes mellitus 5 (25) 2 (10) 7 (17.5) 0.204
Ischemic heart disease 4 (20) 3 (15) 7 (17.5) 0.500
Mitral valve prolapse 0 (0) 1 (5) 1 (2.5) 0.500
Chronic obstructive pulmonary disease 1 (5) 1(5) 2(5) 1.000
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Language:
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Medicine, Clinical Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine
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