Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis
(1) Background: Whether goal-directed fluid therapy (GDFT) provides any outcome benefit as compared to non-goal-directed fluid therapy (N-GDFT) in elective abdominal laparoscopic surgery has not been determined yet. (2) Methods: A systematic literature search was conducted in MEDLINE, Embase, CENTRA...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/5/734 |
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| author | Marcell Virág Máté Rottler Noémi Gede Klementina Ocskay Tamás Leiner Máté Tuba Szabolcs Ábrahám Nelli Farkas Péter Hegyi Zsolt Molnár |
| author_facet | Marcell Virág Máté Rottler Noémi Gede Klementina Ocskay Tamás Leiner Máté Tuba Szabolcs Ábrahám Nelli Farkas Péter Hegyi Zsolt Molnár |
| author_sort | Marcell Virág |
| collection | DOAJ |
| description | (1) Background: Whether goal-directed fluid therapy (GDFT) provides any outcome benefit as compared to non-goal-directed fluid therapy (N-GDFT) in elective abdominal laparoscopic surgery has not been determined yet. (2) Methods: A systematic literature search was conducted in MEDLINE, Embase, CENTRAL, Web of Science, and Scopus. The main outcomes were length of hospital stay (LOHS), time to first flatus and stool, intraoperative fluid and vasopressor requirements, serum lactate levels, and urinary output. Pooled risks ratios (RRs) with 95% confidence intervals (CI) were calculated for dichotomous outcomes and weighted mean difference (WMD) with 95% CI for continuous outcomes. (3) Results: Eleven studies were included in the quantitative, and fifteen in the qualitative synthesis. LOHS (WMD: −1.18 days, 95% CI: −1.84 to −0.53) and time to first stool (WMD: −9.8 h; CI −12.7 to −7.0) were significantly shorter in the GDFT group. GDFT resulted in significantly less intraoperative fluid administration (WMD: −441 mL, 95% CI: −790 to −92) and lower lactate levels at the end of the operation: WMD: −0.25 mmol L<sup>−1</sup>; 95% CI: −0.36 to −0.14. (4) Conclusions: GDFT resulted in enhanced recovery of the gastrointestinal function and shorter LOHS as compared to N-GDFT. |
| first_indexed | 2024-03-10T03:36:30Z |
| format | Article |
| id | doaj.art-37d27693e78f4479b55bb89a7b6806f9 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T03:36:30Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-37d27693e78f4479b55bb89a7b6806f92023-11-23T11:43:53ZengMDPI AGJournal of Personalized Medicine2075-44262022-04-0112573410.3390/jpm12050734Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-AnalysisMarcell Virág0Máté Rottler1Noémi Gede2Klementina Ocskay3Tamás Leiner4Máté Tuba5Szabolcs Ábrahám6Nelli Farkas7Péter Hegyi8Zsolt Molnár9Szentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, HungarySzentágothai Research Centre, Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary(1) Background: Whether goal-directed fluid therapy (GDFT) provides any outcome benefit as compared to non-goal-directed fluid therapy (N-GDFT) in elective abdominal laparoscopic surgery has not been determined yet. (2) Methods: A systematic literature search was conducted in MEDLINE, Embase, CENTRAL, Web of Science, and Scopus. The main outcomes were length of hospital stay (LOHS), time to first flatus and stool, intraoperative fluid and vasopressor requirements, serum lactate levels, and urinary output. Pooled risks ratios (RRs) with 95% confidence intervals (CI) were calculated for dichotomous outcomes and weighted mean difference (WMD) with 95% CI for continuous outcomes. (3) Results: Eleven studies were included in the quantitative, and fifteen in the qualitative synthesis. LOHS (WMD: −1.18 days, 95% CI: −1.84 to −0.53) and time to first stool (WMD: −9.8 h; CI −12.7 to −7.0) were significantly shorter in the GDFT group. GDFT resulted in significantly less intraoperative fluid administration (WMD: −441 mL, 95% CI: −790 to −92) and lower lactate levels at the end of the operation: WMD: −0.25 mmol L<sup>−1</sup>; 95% CI: −0.36 to −0.14. (4) Conclusions: GDFT resulted in enhanced recovery of the gastrointestinal function and shorter LOHS as compared to N-GDFT.https://www.mdpi.com/2075-4426/12/5/734enhanced recovery after surgerygoal-directed fluid therapyintraoperative fluid managementhaemodynamic monitoringlaparoscopic abdominal surgeryperioperative care |
| spellingShingle | Marcell Virág Máté Rottler Noémi Gede Klementina Ocskay Tamás Leiner Máté Tuba Szabolcs Ábrahám Nelli Farkas Péter Hegyi Zsolt Molnár Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis Journal of Personalized Medicine enhanced recovery after surgery goal-directed fluid therapy intraoperative fluid management haemodynamic monitoring laparoscopic abdominal surgery perioperative care |
| title | Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis |
| title_full | Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis |
| title_fullStr | Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis |
| title_short | Goal-Directed Fluid Therapy Enhances Gastrointestinal Recovery after Laparoscopic Surgery: A Systematic Review and Meta-Analysis |
| title_sort | goal directed fluid therapy enhances gastrointestinal recovery after laparoscopic surgery a systematic review and meta analysis |
| topic | enhanced recovery after surgery goal-directed fluid therapy intraoperative fluid management haemodynamic monitoring laparoscopic abdominal surgery perioperative care |
| url | https://www.mdpi.com/2075-4426/12/5/734 |
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