title: Introduction of oesophageal Doppler-guided fluid management in a laparoscopic colorectal surgery enhanced recovery programme: an audit of effect on patient outcome.
abstract: Morbidity after colorectal surgery can be reduced with intraoperative oesophageal Doppler monitor (ODM) guided fluid therapy. We audited the effect of introducing ODM-guided fluid therapy in enhanced recovery laparoscopic colorectal surgery. ODM group (n = 40) outcomes (toleration of diet, Post Operative Morbidity Survery (POMS) score, complications) were compared to matched patients (n = 40) who had the same surgery using a conventional approach to fluid management. Mean (SD) time to tolerate diet was shorter in the ODM group (2.3 (1.6) days vs 3.8 (2.4) days, p = 0.003). The ODM group had a lower mean (SD) POMS score on post-operative day 1 (2 (1.4) vs 4 (1.1), p = 0.001), fewer postoperative complications (14 patients vs 20, p = 0.009) and a lower rate of unplanned critical care area admission (1 vs 6, p= 0.001). Introduction of intraoperative ODM-guided stroke volume optimization was associated with improved outcomes in patients undergoing enhanced recovery laparoscopic colorectal surgery.
authors.forename: M
authors.initials: M
authors.lastname: McKenny
authors.forename: C
authors.initials: C
authors.lastname: O'Malley
authors.forename: B
authors.initials: B
authors.lastname: Mehigan
authors.forename: P
authors.initials: P
authors.lastname: McCormick
authors.forename: N
authors.initials: N
authors.lastname: Dowd
mesh_terms: D000368:Aged; D003082:Colectomy; D004947:Esophagus; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler