Optimization of fluid therapy in elective abdominal surgery

Abstract

The aim of the study was to assess the effect of intraoperative targeted infusion therapy, controlled based on monitoring stroke volume variability, on the postoperative results of major surgical interventions on the organs of the gastrointestinal tract. Materials and Methods: The prospective study included 80 patients who underwent elective surgical interventions on the abdominal organs with the formation of an internecinal anastomosis. In the study group (n = 41), infusion therapy was performed according to the developed protocol of targeted therapy, the key parameter of which was stroke volume variability. In the control group (n = 43), infusion therapy was performed based on the data of routine monitoring of hemodynamics (mean arterial pressure, heart rate, degree of blood loss, taking into account the intraoperative situation). In both groups, surgery was performed under identical conditions (combined anesthesia, identical drugs for induction and maintenance of anesthesia), the difference was in the approach to infusion therapy. Results: In the study group, in comparison with the control group, the intraoperative volume of infusion was less, the number of patients with complications and the total number of complications were significantly lower, and the restoration of the functions of the gastrointestinal tract occurred earlier. Conclusion: Targeted infusion therapy, based on monitoring stroke volume variability as a key parameter, allows optimizing the infusion load and contributes to a decrease in the number of patients with complications, as well as earlier restoration of gastrointestinal tract functions after major surgical abdominal interventions.