Postizanje hemodinamske stabilnosti infuzionim rastvorima ciljanom nadoknadom tečnosti u kolorektalnoj hirurgiji
Hemodynamic stability achievement with infusion solutions by application of goal directed fluid therapy in colorectal surgery
Author
Cvetković, Ana D.Mentor
Kalezić, Nevena
Committee members
Miličić, Biljana
Ivanović, Branislava
Simić, Dušica

Vulović, Tatjana
Metadata
Show full item recordAbstract
Ciljevi istraživanja su procena uticaj primene kristaloidnih rastvora ili
kombinacije koloidnih i kristaloidnih rastvora i njihovih volumena na vrednosti udarnog
i minutnog volumena srca tokom kolorektalne operacija kao i utvrđivanje razlika u:
količini neophodne tečnosti, vremenu do uspostavljanja intraoperativne hemodinamske
stabilnosti, bilansu tečnosti, učestolasti primene vazopresora i inotropa, pojavi
komplikacija, ukupnoj dužini hospitalizacije u ispitivanoj grupi.
Metodologija: Ova randomizovana prospektivna studija obuhvata 80 pacijenata koji su
se podvrgli elektivnoj hirurgiji zbog kolorektalnog karcinoma, na Klinici za onkološku
hirurgiju Instituta za onkologiju i radiologiju Srbije. U kontrolnoj grupi koja je primala
kristaloidni rastvor i u ispitivanoj grupi, koja je primala kombinaciju koloida i
kristaloida, nadoknada je vršena hemodinamskim algoritmom. Merene su
hemodinamske varijable i praćene su komplikacije i dužina boravka u bolnici.
Rezultati: Pacijenti obe grupe bi...li su homogeni po osnovnim osobinama i pretećim
oboljenjima. U kristaloidno-koloidnoj grupi postignute su više vrednosti udarnog
volumena srca nakon sat vremena, do kraja operacije i nakon 24 sata. Vrednost
minutnog volumena srca bila je značajno veća u ovoj grupi na kraju anestezije.
Komlikacije su bile učestalije u kristaloidnoj grupi.
Zaključak: Kombinacija rastvora daje veće vrednosti udarnog i minutnog volumena
srca, brži oporavak i kraći ostanak u bolnici.
Study aim is to estimate impact of crystalloids or colloids and crystalloids
and their volumes on stroke volume and cardiac output during colorectal surgery and to
estimate difference in volumes of these solutions, time till achieved hemodynamic stability,
fluid balance, incidence of vasoactive drugs use, appearance of complications, duration of
hospital stay.
Methods: This is a randomized prospective study with 80 patients who underwent elective
colorectal surgery on Clinic for oncological surgery of Institute for oncology and radiology
of Serbia. In a control group, patients who received crystalloids and in the research group,
patients who received colloids and crystalloids, we used hemodynamic algorithm for goaldirected
fluid therapy. We measured hemodynamic variables such as stroke volume, cardiac
output, cardiac index, mean arterial pressure, oxygen delivery. We recorded complications
and duration of hospitalization.
Results: Patients in both groups were homogenous according to ba...seline characteristics and
comorbidity. Crystalloid-colloid group achieved higher values of stroke volume one hour
from anesthesia induction till the end of surgeru, and after 24 hours. Also values of stroke
volume and cardiac output were higher after 24 hours. Incidence of complications were
higher in crystalloid group according to Clavien-Dindo clasiffication and also these patients
had a longer period of hopitalisation. Both groups had a good hemodynamics.
Conclusion: Combination of solutions provide higher values of stroke volume and cardiac
output, faster postoperative recovery and faster hospital discharge.