The Effect Of Different Kinds Of Fluid Infused With Goal-Direct Fluid Therapy On The Short Outcome In Fast Track Colectomy Patients

[Objective] There are many conflicts on the type and the amount of fluid in peri-operactive fluid management. Recent researches show that goal-directed fluid therapy may reduce postoperative complications and benefit better outcome. However this benefit is thought to be the usage of colloid but lacking of evidence. So in this study we try to find out whether artificial colloid (6%HES130/0.4) can really do better than normal saline in affecting short term outcome of fast-track open colorectal surgery, if given by goal directed strategy.[Methods]16patients who received open colorectal surgery in Zhongshan Hospital department of general surgery from December2010to August2011would be enrolled in this study and equally divided into two groups(HES group and NS group) by random. Ringer’s solution would be given as a background fluid infusion during the surgery, and under the guidance of SVV,6%HES130/0.4or0.9%NS would be given as bolus fluid in either group to reach the setting hemodynamic goal. We compared the time fit for discharge and post-operative complications such as nausea and vomiting, pre and post-operative PT, APTT, NT-pro-BNP and re-hospitalization rate etc. The hypothesis is that6%HES130/0.4can improve patients’short term outcome. All the data would be analyzed by SPSS16.0, the time fit for discharge will be expressed in median value(95%CI) and the other quantitative value will be expressed in mean value±SD. P<0.05is regarded as significant statistical difference.[Results] All the16enrolled patients finished the study. There was no significant difference between two groups in general demographic information and clinical information. The time fit for discharge in HES groups is14.5hours less than that in NS group. Compared with NS group, HES group received much less fluid infusion(P<0.01), and had much less urinary output during the operation(P<0.01). There are no significant differences in occurrence of post-operative complications, peri-operative PT, APTT, NT-pro-BNP changing between two groups(P>0.05). [Conclusion] It seemed that compared with NS, intra-operative goal directed infusing6%HES130/0.4can shorten in-hospital time of fast-track open colorectal surgery. However, as the sample size is too small, the difference is not statistical significant. According to this research, the designated protocol is applicable and it is valuable to apply a multiple-center research to prove positive effect of HES on out come of fast-track surgery. If allowed, increasing the frequency of fit for discharge evaluation may help to reduce the sample size.