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Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery *
Author(s) -
Conway D. H.,
Mayall R.,
AbdulLatif M. S.,
Gilligan S.,
Tackaberry C.
Publication year - 2002
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2002.02708.x
Subject(s) - medicine , stroke volume , hemodynamics , anesthesia , confidence interval , cardiac output , randomized controlled trial , doppler effect , surgery , cardiology , ejection fraction , heart failure , physics , astronomy
Summary Oesophageal Doppler monitoring allows non‐invasive estimation of stroke volume and cardiac output. We studied the impact of Doppler guided fluid optimisation on haemodynamic parameters, peri‐operative morbidity and hospital stay in patients undergoing major bowel surgery. Fifty‐seven patients were randomly assigned to Doppler (D) or control (C) groups. All patients received intra‐operative fluid therapy at the discretion of the non‐investigating anaesthetist. In addition, Group D were given fluid challenges (3 ml.kg −1 ) guided by oesophageal Doppler. Group D received significantly more intra‐operative colloid than Group C (mean 28 (SD 16) vs. 19.4 (SD 14.7) ml.kg −1 , p = 0.02). Cardiac output increased significantly for Group D whilst that of controls remained unchanged. The mean difference between the groups in final cardiac output was 0.87 l.min −1 (95% confidence interval 0.31–1.43 l.min −1 , p = 0.003). Five control patients required postoperative critical care admission. Fluid titration using oesophageal Doppler during bowel surgery can improve haemodynamic parameters and may reduce critical care admissions postoperatively.