The Effect Of Goal-directed Fluid Therapy On Elderly Patients After Gastrointestinal Surgery

Objective:To investigate the effect of goal-directed fluid therapy on elderly patients after gastrointestinal surgery.Methods:sixty patients undergoing gastrointestinal tumor radical operation (age was no less than 60 years old, ASA Ⅱ OR Ⅲ) were included and randomly divided into two groups based on fluid therapy:conventional fluid therapy(group C) and goal-directed fluid therapy (group G). Group C received conventional fluid therapy according to the change of blood pressure during operation, maintaining mean arterial pressure at 60～110mmHg. Whereas group G received goal-directed fluid therapy, we could get the stroke volume variation, cardiac index, and stroke volume index et al through the Flotrac/Vigileo. The goals of group G were maintaining at stroke volume variation 2%-13%, cardiac index 2.5～4.0L·min-1·m-2, stroke volume index 35-47 ml·m-2, MAP 65～110mmHg. Record the total volume of liquid, the crystal volume, colloid volume. The first time of exhaust time after operation,total hospital stay, postoperative hospital stay and the total medical expenses were recorded.Results:Compared with conventional fluid therapy group, patients in goad-directed fluid therapy group received less crystal solution, colloid solution and total solution. The rate of using vasoactive drugs was higher in goal-directed fluid therapy group than in conventional fluid therapy group. The incidence of postoperative pulmonary complications was lower. The first time of exhaust time after operation was earlier, postoperative hospital stay, total hospital stay was shorter and the total medical expenses was cheaper than those in conventional fluid therapy.Conclusion(s):GDFT can improve the prognosis in elderly patients after gastrointestinal surgery, reduce postoperative pulmonary complications,shorten the hospital stay and save medical resources.