Premium
Intraoperative goal‐directed hemodynamic management in free tissue transfer for head and neck cancer
Author(s) -
Hand William R.,
Stoll William D.,
McEvoy Matthew D.,
McSwain Julie R.,
Sealy Clark D.,
Skoner Judith M.,
Hornig Joshua D.,
Tennant Paul A.,
Wolf Bethany,
Day Terry A.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24362
Subject(s) - medicine , head and neck cancer , hemodynamics , head and neck , perioperative , intensive care unit , anesthesia , blood pressure , randomized controlled trial , surgery , cancer , intensive care medicine
Background The purpose of this study was to determine the effect of algorithmic physiologic management on patients undergoing head and neck free tissue transfer and reconstruction. Methods Ninety‐four adult patients were randomized to treatment and control groups. The blood pressure of the control group was managed consistent with contemporary standards. The treatment group was managed using an algorithm based on blood pressure and calculated physiologic values derived from arterial waveform analysis. Primary outcome was intensive care unit (ICU) length of stay. Results ICU length of stay was decreased in the treatment group (33.7 vs 58.3 hours; p = .026). The complication rate was not increased in the treatment group. Conclusion The goal‐directed hemodynamic management algorithm decreased the ICU length of stay. Judicious use of vasoactive drugs and goal‐directed fluid administration has a role in improving perioperative outcomes for patients undergoing head and neck free tissue transfer. © 2016 Wiley Periodicals, Inc. Head Neck 38 : E1974–E1980, 2016