To compare the goal-directed fluid therapy based on the data obtained from the hemodynamic monitoring system, which provides continuous CO, SV and SVV measurements through arterial pressure wave with standard fluid therapy in perioperative fluid management of patients undergoing head and neck surgery.
Following the ethics committee approval and patients consent, the study was completed with a total of ASA I-III, 60 patients over the age of 18 who will undergo head and neck surgery.After randomization, patients underwent arterial cannulation. The arterial cannulas of the study group patients were integrated into the hemodynamic monitoring system with a special transducer, and their fluid management was planned to achieve a target value of 13% or less through SVV monitoring. In the control group, fluid management was set as MAP (Mean arterial pressure) 65 mmHg and above and diuresis 0.5ml/kg/hour and above. Crystalloid infusion at 7ml/kg/hour was started in both groups. When SVV value increased to 13% and over in the study group, 250 ml of crystalloid was given in the first stage, and if it continued to be 13% and over, 250 ml of colloid bolus was given. Vasoconstrictor agent was used when SVV was below 13% and MAP was below 65 mmHg. The patients in the control group were given 250 ml of crystalloid in the first stage if the MAP was below 65 mmHg, and 250 ml of colloid bolus if the hypotensive episode continued. If hypotension persisted despite these fluid boluses, a vasoconstrictor agent was used. In addition, when the diuresis of the patients was detected at 0.5mg/kg/hr or less, 250 ml of colloid bolus was administered.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Crystalloid solution is a true solution and is able to pass through a semipermeable membrane.
Colloid solution is a heterogeneous mixture whose particle size is intermediate between those of a solution and a suspension.
Istanbul University, Department of Anesthesiology
Istanbul, Fatih, Turkey (Türkiye)
Intraoperative fluid balance
the total and additional amount of crystalloid and colloid fluid fluid given during the surgery
Time frame: during surgery
Prolonged IMV demand
The need for artificial respiration for 8 hours or more in patients admitted to the postoperative intensive care unit.
Time frame: during 8 hours after surgery
Prolonged oxygen demand
The need for additional oxygen application with a mask for 8 hours or more in patients who are taken into postoperative service follow-up.
Time frame: during 8 hours after surgery
Heart rate
EKG
Time frame: during surgery
Blood Pressure
Arterial line and pressure transducer
Time frame: during surgery
hospitalisation time
calendar
Time frame: postoperative period (up to 6 weeks)
lenght of stay in ICU
calendar
Time frame: postoperative period (up to 6 weeks)
hypoxia
blood gas machine
Time frame: during surgery
hypercarbia
blood gas machine
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Time frame: during surgery
pulmonary infection
sputum culture test
Time frame: postoperative period (up to 6 weeks)