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Goal-Directed Fluid Therapy and major postoperative complications in elective craniotomy. A retrospective analysis of a before-after multicentric study.
- Source :
-
BMC Anesthesiology . 1/13/2023, Vol. 23 Issue 1, p1-7. 7p. - Publication Year :
- 2023
-
Abstract
- Background: Goal-Directed Fluid Therapy (GDFT) is recommended to decrease major postoperative complications. However, data are lacking in intra-cranial neurosurgery. Methods: We evaluated the efficacy of a GDFT protocol in a before/after multi-centre study in patients undergoing elective intra-cranial surgery for brain tumour. Data were collected during 6 months in each period (before/after). GDFT was performed in high-risk patients: ASA score III/IV and/or preoperative Glasgow Coma Score (GCS) < 15 and/or history of brain tumour surgery and/or tumour greater size ≥ 35 mm and/or mid-line shift ≥ 3 mm and/or significant haemorrhagic risk. Major postoperative complication was a composite endpoint: re-intubation after surgery, a new onset of GCS < 15 after surgery, focal motor deficit, agitation, seizures, intra-cranial haemorrhage, stroke, intra-cranial hypertension, hospital-acquired related pneumonia, surgical site infection, cardiac arrythmia, invasive mechanical ventilation ≥ 48 h and in-hospital mortality. Results: From July 2018 to January 2021, 344 patients were included in 3 centers: 171 in the before and 173 in the after (GDFT) period. Thirty-six (21.1%) patients displayed a major postoperative complication in the Before period, and 50 (28.9%) in the After period (p = 0.1). In the propensity score analysis, we matched 48 patients in each period: 9 (18.8%) patients in the After period and 14 (29.2%) patients in the Before period displayed a major perioperative complication (p = 0.2). Sixty-two (35.8%) patients received GDFT in the After period, with great heterogeneity among centers (p < 0.05). Conclusions: In our before-after study, GDFT was not associated with a decrease in postoperative major complications in elective intra-cranial neurosurgery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ELECTIVE surgery
*RESEARCH
*PNEUMONIA
*FLUID therapy
*NEUROSURGERY
*TIME
*INTRACRANIAL hemorrhage
*SURGICAL complications
*RETROSPECTIVE studies
*BRAIN tumors
*NOSOCOMIAL infections
*ARTIFICIAL respiration
*HOSPITAL mortality
*GLASGOW Coma Scale
*SURGICAL site infections
*DESCRIPTIVE statistics
*CRANIOTOMY
*PSYCHOMOTOR disorders
*SEIZURES (Medicine)
*ARRHYTHMIA
*DATA analysis software
*GOAL (Psychology)
*INTRACRANIAL hypertension
BRAIN tumor diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 23
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 161271823
- Full Text :
- https://doi.org/10.1186/s12871-022-01962-5