Goal directed fluid resuscitation decreases time for lactate clearance and facilitates early fascial closure in damage control surgery - 02/12/13
Abstract |
Background |
Damage-control surgery frequently results in open abdomen. The objective of this study was to determine whether resuscitation with goal-directed fluid therapy (GDT) using “dynamic” hemodynamic indices via modern pulse contour analysis devices such as the FloTrac Vigileo monitor leads to lower fluid requirements, subsequent quicker abdominal closure, and overall improved outcomes in these patients.
Methods |
Patients admitted to the surgical intensive care unit with open abdomen were retrospectively reviewed. Those resuscitated with Vigileo-guided GDT were matched to those resuscitated by static clinical parameters.
Results |
Total fluid intake and vasopressor requirements were similar in both groups. GDT with the Vigileo allowed earlier lactate clearance and reduced the number of days until abdominal wall closure by an average of .99 days.
Conclusions |
Vigileo-mediated GDT did not affect fluid volume or vasopressor use in open abdomen patients, but facilitated more effective resuscitation and decreased the number of days to fascial closure, leading to shorter hospital stays. Vigileo-mediated GDT, therefore, may improve overall outcomes in open abdomen patients.
Le texte complet de cet article est disponible en PDF.Keywords : Damage control surgery, Open abdomen, Goal-directed therapy, Early abdominal wall closure, Early lactate clearance, Vigileo
Plan
| The authors declare no conflicts of interest. |
Vol 206 - N° 6
P. 995-1000 - décembre 2013 Retour au numéro
Article précédent
- Is magnetic resonance imaging in addition to a computed tomographic scan necessary to identify clinically significant cervical spine injuries in obtunded blunt trauma patients?
- Brian M. Fisher, Steven Cowles, Jennifer R. Matulich, Bradley G. Evanson, Diana Vega, Sharmila Dissanaike
- Pneumomediastinum: etiology and a guide to diagnosis and treatment
- Farzaneh Banki, Anthony L. Estrera, Ryan G. Harrison, Charles C. Miller, Samuel S. Leake, Kyle G. Mitchell, Kamal Khalil, Hazim J. Safi, Larry R. Kaiser
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?