The influence of goal-directed fluid therapy on the prognosis of elderly patients with hypertension and gastric cancer surgery.
OBJECTIVE
We aimed to investigate the influence of perioperative goal-directed fluid therapy (GDFT) on the prognosis of elderly patients with gastric cancer and hypertension.


METHODS
Sixty elderly patients (>60 years old) with primary hypertension who received gastric cancer radical surgery and who were American Society of Anesthesiologists (ASA) class II or III were enrolled in the current study. Selected patients were divided randomly into two arms, comprising a conventional intraoperative fluid management arm (arm C, n=30) and a GDFT arm (arm G, n=30). Patients in arm C were infused with crystalloids or colloids according to the methods of Miller's Anesthesia (6th edition), while those in arm G were infused with 200 mL hydroxyethyl starch over 15 minutes under the FloTrac/Vigileo monitoring system, with stroke volume variation between 8% and 13%. Hemodynamics and tissue perfusion laboratory indicators in patients were recorded continuously from 30 minutes before the operation to 24 hours after the operation.


RESULTS
Compared with arm C, the average intraoperative intravenous infusion quantity in arm G was significantly reduced (2,732±488 mL versus 3,135±346 mL, P<0.05), whereas average colloid fluid volume was significantly increased (1,235±360 mL versus 760±280 mL, P<0.05). In addition, there were more patients exhibiting intraoperatively and postoperatively stable hemodynamics and less patients with low blood pressure in arm G. Postoperative complications were less frequent, and the time of postoperative hospital stay shorter, in arm G. No significant differences were observed in mortality between the two arms.


CONCLUSIONS
Our research showed that GDFT stabilized perioperative hemodynamics and reduced the occurrence of postoperative complications in elderly patients who underwent gastric cancer surgery.
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Kai
K
Zeng
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Yanzhen
Y
Li
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Min
M
Liang
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Youguang
Y
Gao
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Hongda
H
Cai
Department of Anesthesia, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
Caizhu
C
Lin
D000368:Aged; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery
gastric cancer; stroke volume variation; the elderly