Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis
Abstract Background An understanding of the impact of goal-directed fluid therapy (GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV) for thoracic surgery remains incomplete and controversial. This meta-analysis aimed to assess the effect of GDFT compared to other fluid therapy...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03169-5 |
| _version_ | 1827710688496189440 |
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| author | Xuan Li Qinyu Zhang Yuyang Zhu Yihan Yang Wenxia Xu Yufei Zhao Yuan Liu Wenqiang Xue Yu Fang Jie Huang |
| author_facet | Xuan Li Qinyu Zhang Yuyang Zhu Yihan Yang Wenxia Xu Yufei Zhao Yuan Liu Wenqiang Xue Yu Fang Jie Huang |
| author_sort | Xuan Li |
| collection | DOAJ |
| description | Abstract Background An understanding of the impact of goal-directed fluid therapy (GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV) for thoracic surgery remains incomplete and controversial. This meta-analysis aimed to assess the effect of GDFT compared to other fluid therapy strategies on the incidence of postoperative complications in patients with OLV. Methods The Embase, Cochrane Library, Web of Science, and MEDLINE via PubMed databases were searched from their inception to November 30, 2022. Forest plots were constructed to present the results of the meta-analysis. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Risk Of Bias In Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was the incidence of postoperative complications. Secondary outcomes were the length of hospital stay, PaO2/FiO2 ratio, total fluid infusion, inflammatory factors (TNF-α, IL-6), and postoperative bowel function recovery time. Results A total of 1318 patients from 11 studies were included in this review. The GDFT group had a lower incidence of postoperative complications [odds ratio (OR), 0.47; 95% confidence interval (95% CI), 0.29–0.75; P = 0.002; I 2, 67%], postoperative pulmonary complications (OR 0.48, 95% CI 0.27–0.83; P = 0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27–0.97; P = 0.04). The GDFT strategy reduces total fluid infusion. Conclusions GDFT is associated with lower postoperative complications and better survival outcomes after thoracic surgery for OLV. |
| first_indexed | 2024-03-10T17:42:20Z |
| format | Article |
| id | doaj.art-059bd28c35ef462cbf6730ed2c9a0c1f |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-10T17:42:20Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-059bd28c35ef462cbf6730ed2c9a0c1f2023-11-20T09:37:28ZengBMCWorld Journal of Surgical Oncology1477-78192023-09-0121111410.1186/s12957-023-03169-5Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysisXuan Li0Qinyu Zhang1Yuyang Zhu2Yihan Yang3Wenxia Xu4Yufei Zhao5Yuan Liu6Wenqiang Xue7Yu Fang8Jie Huang9Department of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Kunming Medical UniversityAbstract Background An understanding of the impact of goal-directed fluid therapy (GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV) for thoracic surgery remains incomplete and controversial. This meta-analysis aimed to assess the effect of GDFT compared to other fluid therapy strategies on the incidence of postoperative complications in patients with OLV. Methods The Embase, Cochrane Library, Web of Science, and MEDLINE via PubMed databases were searched from their inception to November 30, 2022. Forest plots were constructed to present the results of the meta-analysis. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Risk Of Bias In Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was the incidence of postoperative complications. Secondary outcomes were the length of hospital stay, PaO2/FiO2 ratio, total fluid infusion, inflammatory factors (TNF-α, IL-6), and postoperative bowel function recovery time. Results A total of 1318 patients from 11 studies were included in this review. The GDFT group had a lower incidence of postoperative complications [odds ratio (OR), 0.47; 95% confidence interval (95% CI), 0.29–0.75; P = 0.002; I 2, 67%], postoperative pulmonary complications (OR 0.48, 95% CI 0.27–0.83; P = 0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27–0.97; P = 0.04). The GDFT strategy reduces total fluid infusion. Conclusions GDFT is associated with lower postoperative complications and better survival outcomes after thoracic surgery for OLV.https://doi.org/10.1186/s12957-023-03169-5Goal-directed fluid therapyMeta-analysisOne-lung ventilationPostoperative complicationsPulmonary protection |
| spellingShingle | Xuan Li Qinyu Zhang Yuyang Zhu Yihan Yang Wenxia Xu Yufei Zhao Yuan Liu Wenqiang Xue Yu Fang Jie Huang Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis World Journal of Surgical Oncology Goal-directed fluid therapy Meta-analysis One-lung ventilation Postoperative complications Pulmonary protection |
| title | Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis |
| title_full | Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis |
| title_fullStr | Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis |
| title_short | Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis |
| title_sort | effect of perioperative goal directed fluid therapy on postoperative complications after thoracic surgery with one lung ventilation a systematic review and meta analysis |
| topic | Goal-directed fluid therapy Meta-analysis One-lung ventilation Postoperative complications Pulmonary protection |
| url | https://doi.org/10.1186/s12957-023-03169-5 |
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