Sandeep Sahu
Sanjay Gandhi Postgraduate Institute of Medical Sciences, India
Title: Study on the intraoperative transesophageal Doppler-guided versus central venous pressure-guided fluid therapy on renal allograft outcome in recipients undergoing living donor renal transplantation
Biography
Biography: Sandeep Sahu
Abstract
Background & Aim: Transesophageal Doppler (TED)-guided intraoperative fluid therapy has shown to noninvasively optimize intravascular volume and reduce postoperative morbidity. The aim of this study was to compare the effects of Doppler-guided intraoperative fluid administration and central venous pressure (CVP)-guided fluid therapy on renal allograft outcome and postoperative complications.
Material & Methods: A prospective nonrandomized active controlled study was conducted on end-stage renal disease patients scheduled for living donor renal transplant surgery. 110 patients received intraoperative fluid guided by corrected flow time (FTc) and variation in stroke volume values obtained by continuous TED monitoring. Data of 104 patients in whom intraoperative fluid administration was guided by CVP values were retrospectively obtained for a control.
Results: The amount of intraoperative fluid given in the study group (12.20±2.24 ml/kg/h) was significantly lower than in the controls (22.21±4.67 ml/kg/h). The amount of colloid used was also significantly less and fewer recipients were seen to require colloid (69 vs. 85%). The mean arterial pressures were comparable throughout. CVP reached was 7.18±3.17 mmHg in the study group. It was significantly higher in the controls (13.42±3.12 mmHg). The postoperative graft function and rate of dysfunction were comparable. Side-effects like postoperative dyspnoea (4.8 vs. 0%) and tissue edema (9.6 vs. 2.7%) were higher in the controls.