Feasibility of Goal-Directed Fluid Therapy in Patients with Transcatheter Aortic Valve Replacement - An Ambispective Analysis

被引:0
作者
Trauzeddel, Ralf Felix [1 ,2 ,3 ]
Nordine, Michael [4 ]
Fucini, Giovanni B. [5 ,6 ,7 ]
Sander, Michael [3 ]
Dreger, Henryk [8 ,9 ,10 ]
Stangl, Karl [11 ,12 ]
Treskatsch, Sascha [1 ,2 ,3 ]
Habicher, Marit [3 ]
机构
[1] Charite Univ Med Berlin, Dept Anesthesiol & Intens Care Med, Berlin, Germany
[2] Free Univ Berlin, Berlin, Germany
[3] Humboldt Univ, Campus Benjamin Franklin, Berlin, Germany
[4] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Anesthesiol Intens Care Med & Pain Therapy, Frankfurt, Germany
[5] Inst Hyg & Environm Med, Berlin, Germany
[6] Charite Univ Med Berlin, Natl Reference Ctr Surveillance Nosocomial Infect, Berlin, Germany
[7] Humboldt Univ, Berlin, Germany
[8] Justus Liebig Univ Giessen, Dept Anesthesiol Operat Intens Care Med & Pain The, Hessen, Germany
[9] Deutsch Herzzentrum Charite Med Heart Ctr Charite, Dept Cardiol Angiol & Intens Care Med, Berlin, Germany
[10] Campus Virchow Klinikum, German Heart Inst Berlin, Berlin, Germany
[11] Deutsch Herzzentrum Charite Med Heart Ctr Charite, Dept Cardiol & Angiol, Berlin, Germany
[12] Campus Charite Mitte, German Heart Inst Berlin, Berlin, Germany
关键词
Atrial Fibrilation; Transcatheter Aortic Valve Replacemnet; Stroke Volume; Control Groups; Incidence; Cardiac Conduction System Disease; Fluid Therapy; Ischemia; Delirium; PULSE CONTOUR ANALYSIS; GUT MUCOSAL HYPOPERFUSION; CARDIAC-SURGERY; CONTROLLED-TRIAL; POSTOPERATIVE COMPLICATIONS; HYDROXYETHYL STARCH; HOSPITAL STAY; ARTERIAL; RISK; METAANALYSIS;
D O I
10.21470/1678-9741-2022-0470
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Goal -directed fluid therapy (GDFT) has been shown to reduce postoperative complications. The feasibility of GDFT in transcatheter aortic valve replacement (TAVR) patients under general anesthesia has not yet been demonstrated. We examined whether GDFT could be applied in patients undergoing TAVR in general anesthesia and its impact on outcomes. Methods: Forty consecutive TAVR patients in the prospective intervention group with GDFT were compared to 40 retrospective TAVR patients without GDFT. Inclusion criteria were age >= 18 years, elective TAVR in general anesthesia, no participation in another interventional study. Exclusion criteria were lack of ability to consent study participation, pregnant or nursing patients, emergency procedures, preinterventional decubitus, tissue and/or extremity ischemia, peripheral arterial occlusive disease grade IV, atrial fibrillation or other severe heart rhythm disorder, necessity of usage of intra-aortic balloon pump. Stroke volume and stroke volume variation were determined with uncalibrated pulse contour analysis and optimized according to a predefined algorithm using 250 ml of hydroxyethyl starch. Results: Stroke volume could be increased by applying GDFT. The intervention group received more colloids and fewer crystalloids than control group. Total volume replacement did not differ. The incidence of overall complications as well as intensive care unit and hospital length of stay were comparable between both groups. GDFT was associated with a reduced incidence of delirium. Duration of anesthesia was shorter in the intervention group. Duration of the interventional procedure did not differ. Conclusion: GDFT in the intervention group was associated with a reduced incidence of postinterventional delirium.
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页数:11
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