Wide excision of head and neck cancer with microsurgical free flap's reconstruction (FFR) results to a high cancer cure rate and a good functional recovery. However, this long complex procedure is accompanied with considerable complications. Excessive fluid administration during this type of surgery has been connected with poor results. There is growing evidence that goal-directed fluid management (GDFM) might improve the results in high-risk patients. Hypothesis: Goal directed fluid management will reduce intraoperative fluid volume administered to patients undergoing head and neck reconstructive surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
78
Baseline SV measurement, repeated volume loading (VL) with aliquots of 250 ml HES until SV increased \< 10% in response to receding VL: SV is optimized, no further VL required.
Toronto General Hospital, UHN
Toronto, Ontario, Canada
The volume of fluid administered intraoperatively during reconstructive surgery for head and neck oncology
Time frame: Initiation of surgery to end of surgery on average 8-10 hours
Incidence of major complication and LOS
Cardiovascular, respiratory, neurologic, thromboembolic, renal,liver, GI, sepsis,and surgical complications willl be recorded
Time frame: Post operative day 0 to hospital discharge
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