AUTHOR=Gao Ming , Chen Minggan , Dai Gang , Zhu Dengfeng , Cai Yiting 

TITLE=Clinical study: the impact of goal-directed fluid therapy on volume management during enhanced recovery after surgery in gastrointestinal procedures

JOURNAL=Acta Biochimica Polonica

VOLUME=Volume 71 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/acta-biochimica-polonica/articles/10.3389/abp.2024.12377

DOI=10.3389/abp.2024.12377

ISSN=1734-154X

ABSTRACT=Backgournd: Goal-oriented fluid therapy, as a crucial component of accelerated rehabilitation surgery, plays a significant role in expediting postoperative recovery and enhancing the prognosis of major surgical procedures. 
 
Methods: In line with this, the present study aims to investigate the impact of target-oriented fluid therapy on volume management during ERAS protocols specifically for gastrointestinal surgery. Our hospital selected patients undergoing gastrointestinal surgery between October 2019 and May 2021 as the sample population for this research.

Results: 41 cases of gastrointestinal surgery patients were collected from our hospital in recent 3 years. Compared with T1, MAP level increased significantly from T2 to T5, cardiac output (CO) level decreased significantly from T2 to T3, CO level increased significantly from T4 to T5, and SV level increased significantly from T3 to T5. Compared with T2, HR and cardiac index (CI) levels of T1 and T3-T5 were significantly higher. Compared with T3, SVV level was significantly decreased at T1, T2, T4 and T5. CO and stroke volume (SV)  levels increased significantly at T4 and T5. In this study, Taking time of pressor drug = 23 days, PACU residence time = 40.22±12.79 min, time for getting out of bed = 12.41±3.97 h, exhaust and defecation time = 18.11±7.52 h, and Postoperative hospital stay = 4.47±1.98 days. HAMA Score = 9.11±2.37, CRP levels = 10.54±3.38 mg/L, Adrenaline levels = 132.87±8.97 ng/L, and Cortisol levels = 119.72±4.08 ng/L. At 3 d after surgery, Prealbumin levels = 141.98±10.99 mg/L, and Prealbumin levels at the day of leave hospital = 164.17±15.84 mg/L. Lymphocyte count at 3 d after surgery = 1.22±0.18 (10 9 /L), and Lymphocyte count at the day of leave hospital = 1.47±0.17 (10 9 /L). Serum albumin levels at 3 d after surgery = 30.51±2.28 (g/L), and Serum albumin levels at the day of leave hospital = 33.52±2.07 (g/L). 
Conclusions: Goal directed fluid therapy (GDFT) under Enhanced Recovery After Surgery (ERAS)  concept is helpful to volume management during radical resection of colorectal tumors, with good postoperative recovery. Pay attention to the influence of pneumoperitoneum and intraoperative posture on GDFT parameters.