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Effects of perioperative goal-directed fluid therapy combined with the application of alpha-1 adrenergic agonists on postoperative outcomes: a systematic review and meta-analysis
- Source :
- BMC Anesthesiology, Vol 18, Iss 1, Pp 1-13 (2018), BMC Anesthesiology
- Publication Year :
- 2018
- Publisher :
- BMC, 2018.
-
Abstract
- Background Past studies have demonstrated that goal-directed fluid therapy (GDFT) may be more marginal than previously believed. However, beneficial effects of alpha-1 adrenergic agonists combined with appropriate fluid administration is getting more and more attention. This study aimed to systematically review the effects of goal-directed fluid therapy (GDFT) combined with the application of alpha-1 adrenergic agonists on postoperative outcomes following noncardiac surgery. Methods This meta-analysis included randomized controlled trials (RCTs) on GDFT combined with the application of alpha-1 adrenergic agonists in patients undergoing noncardiac surgery. The primary outcomes included the postoperative mortality rate and length of hospital stay (LOS). The secondary outcome indexes were the incidence of postoperative complications and recovery of postoperative gastrointestinal (GI) function. The traditional pairwise meta-analysis was conducted to compare the effect of fluid therapy. The quality of included RCTs was evaluated according to the Cochrane Collaboration’s risk-of-bias tool. Also, the publication bias was detected using funnel plots, Egger’s regression test, and Begg’s adjusted rank correlation test. The meta-analysis was conducted using the RevMan 5.3 and Stata 14.0 software. Results Thirty-two eligible RCTs were included in this meta-analysis. Perioperative GDFT combined with the application of alpha-1 adrenergic agonists was associated with a significant reduction in LOS (P = 0.002; I2 = 69%), and overall complication rates (P = 0.04; I2 = 41%). It facilitated gastrointestinal function recovery, as demonstrated by shortening the time to first flatus by 6.30 h (P
- Subjects :
- Funnel plot
medicine.medical_specialty
Gastrointestinal Diseases
Adrenergic
Perioperative Care
Goal-directed fluid therapy
law.invention
lcsh:RD78.3-87.3
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Randomized controlled trial
030202 anesthesiology
law
Anesthesiology
Medicine
Humans
Mortality
business.industry
Alpha-1 adrenergic agonists
Noncardiac surgery
030208 emergency & critical care medicine
Publication bias
Perioperative
Length of Stay
Anesthesia management
Length of hospital stay
Anesthesiology and Pain Medicine
lcsh:Anesthesiology
Anesthesia
Meta-analysis
Fluid Therapy
Adrenergic alpha-1 Receptor Agonists
Morbidity
business
Gastrointestinal function
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Anesthesiology
- Accession number :
- edsair.doi.dedup.....6c7648e887503e0749f68f149eabbcbb