Comparison of esophageal Doppler and plethysmographic variability index to guide intraoperative fluid therapy for low-risk patients undergoing colorectal surgery.
OBJECTIVE
This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery.


METHODS
Randomized controlled trial.


METHODS
Operating room.


METHODS
Forty low-risk patients undergoing elective colorectal surgery.


METHODS
Patients were monitored by esophageal Doppler and PVI probes and were randomized to have fluid therapy directed by using one of these technologies, with 250 mL boluses of colloid to maintain a maximal stroke volume, or a PVI of less than 14%.


METHODS
Absolute volumes of fluid volumes given intraoperatively were measured as were 24 hours fluid volumes. Perioperative measurements of lactate and base excess were recorded as were postoperative complications.


RESULTS
There was no significant difference between PVI and esophageal Doppler groups in mean total fluid administered (1286 vs 1520 mL, P=.300) or mean intraoperative fluid balance (+839 v+1145 mL, P=.150).


CONCLUSIONS
PVI offers an entirely non-invasive alternative for goal-directed fluid therapy in this group of patients.
York Teaching Hospital NHS Foundation Trust, Wigginton Road, York, North Yorkshire, United Kingdom, YO31 8HE.
Samantha R
SR
Warnakulasuriya
York Teaching Hospital NHS Foundation Trust, Wigginton Road, York, North Yorkshire, United Kingdom, YO31 8HE. Electronic address: simon.davies@york.nhs.uk.
Simon J
SJ
Davies
York Teaching Hospital NHS Foundation Trust, Wigginton Road, York, North Yorkshire, United Kingdom, YO31 8HE.
R Jonathan T
RJ
Wilson
York Teaching Hospital NHS Foundation Trust, Wigginton Road, York, North Yorkshire, United Kingdom, YO31 8HE.
David R A
DR
Yates
D000368:Aged; D003106:Colon / Q000601:surgery*; D015150:Echocardiography, Doppler / Q000009:adverse effects; D017548:Echocardiography, Transesophageal / Q000009:adverse effects; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010991:Plethysmography / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012007:Rectum / Q000601:surgery*; D013318:Stroke Volume
D019344:Lactic Acid
Cardiac output; Colorectal surgery; Doppler ultrasonography; Fluid therapy; Plethysmography