Effect of intraoperative fluid optimisation on postoperativemorbidity score in patients undergoing emergency abdominalsurgery; a randomised controlled pilot study

Background and Goal of the Study : This pilot study aims to examine the effect of goal directed therapy using fluid alone on postoperative morbidity score (PMS) in patients following emergency abdominal surgery [1]. Materials and Methods : This prospective randomized study included patients over the age of 50 undergoing emergency abdominal surgery. Patients presenting following trauma, undergoing vascular surgery or who were on lithium therapy were excluded from the study. Research ethic committee approval and informed consent was obtained. In the intervention group the Lidco monitor (Lidco plus system, Lidco Ltd., UK) was used to guide fluid boluses of 250ml of 6% Hydroxyethylstarch 130/0.4 (Voluven, Fresenius Ltd., UK) based on pulse pressure variation measurement (bolus given if >10%). The control group received standard care. PMS were measured postoperatively on days 5 and 15 and 30. Data are median (range) and were analyzed using chisquare test or Mann Whitney test as appropriate. Results : 30 patients were recruited. Their age was 65 yrs (51-76), 23 patients were male, ASA = 3 (1-4), Lee risk score = 3 (2-4). One patient died prior to surgery and was excluded from the analysis.10 patients had upper and 19 lower abdominal surgery. Duration of surgery was 110 min (40-295). There were no demographic differences between the groups. The intervention group received a median of 750ml of hydroxyethylstarch. On day 5 and 30 there were no differences in PMS scores. Day 15 data as displayed in table. Conclusions : Goal directed therapy using fluid alone may be associated with an increased incidence of in hospital stay at 15 days.