الفهرس 
Functional Hemodynamic MonitoringOnly 14 pages are availabe for public view
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Abstract
Non-Calibrated Pulse-Contour Analysis for Monitoring Adequacy of Tissue Perfusion in Major Abdominal Surgeries in Perioperative Period
Sharaf I. Samia, MD, Kamaly M. Ayman, MD, Elgendy A. Mohammed, MD, Hussin M. Rania, MD, Eldeeb A. Mohammed, M.SC.
Abstract:
Introduction: During major abdominal surgeries, incidence of major blood loss as well as major fluid loss is an acute risk factor. If the fluid is not replenished in the perioperative period, can lead to increased risk of complications, including cardiac and respiratory failure, cognitive impairment and physiologic reaction to the infection due to lack of the oxygenation and organ perfusion. To potentially improve outcomes and reduce complications, monitoring modalities that reflect the patient’s dynamic intra vascular physiology in real time should be employed. Increasingly, clinicians have turned to haemodynamic assessment to measure cardiac output to guide vasopressor support for oxygen delivery, organ perfusion, blood pressure, as well as the use of appropriate anesthetic. Data has shown that using haemodynamic assessment to guide fluid management leads to reduce hypovolemia and hypoperfusion. Using measurement of stroke volume, stroke volume variation and pulse pressure variation.
Patients and methods: The current study was a single center, prospective randomized controlled clinical trial that estimate the efficacy of using non calibrated pulse-contour analysis using Vigileo/FloTrac monitor for monitoring adequacy of tissue perfusion in major abdominal surgeries in perioperative period. Eighty patients was included in the study who are 18-70 years of age with an ASA score II or III, with one or more risk factors according to risk index of lee, underwent major abdominal surgeries, the patients meeting inclusion criteria were randomized preoperatively into conventional resuscitation group (conv-group) and cardiac output resuscitation group (CO-group). Randomization was performed using serially numbered opaque envelopes.
The aim of the study is to assess the use of the optimizing protocol using non-calibrated pulse-contour analysis for monitoring adequacy of tissue perfusion in major abdominal surgeries in perioperative period compared with standard protocol based on conventional haemodynamic resuscitation strategy.
Results: The results of the study had show that there is significant reduction in the number of the complications in the cardiac out-put group in comparison with conventional resuscitation group and there were significant reduction in ICU stay as well as hospital stay.
Conclusion: We conclude, this is single-center study on perioperative use of cardiac output monitoring in major abdominal surgeries. The results support the use of cardiac output monitoring in high risk patients undergoing major abdominal surgeries in order to reduce complications and, therefore, patient morbidity.
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