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| Format: | Artículo científico |
| Language: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2024
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| Online Access: | https://www.redalyc.org/articulo.oa?id=398977617006 https://www.redalyc.org/journal/3989/398977617006/ https://www.redalyc.org/journal/3989/398977617006/html/ https://www.redalyc.org/journal/3989/398977617006/398977617006.epub https://www.redalyc.org/journal/3989/398977617006/movil https://doi.org/10.21470/1678-9741-2022-0470 |
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Table of Contents:
- Feasibility of Goal-Directed Fluid Therapy in Patients with Transcatheter Aortic Valve Replacement - An Ambispective Analysis Ralf Felix Trauzeddel Michael Nordine Giovanni B. Fucini Michael Sander Henryk Dreger Karl Stangl Sascha Treskatsch Marit Habicher Medicina Ischemia Delirium Incidence Stroke Volume Fluid Therapy 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. 2024 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398977617006 https://www.redalyc.org/journal/3989/398977617006/ https://www.redalyc.org/journal/3989/398977617006/html/ https://www.redalyc.org/journal/3989/398977617006/398977617006.epub https://www.redalyc.org/journal/3989/398977617006/movil https://doi.org/10.21470/1678-9741-2022-0470 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.39