The Accuracy And Effectiveness Of Goal Directed Fluid Therapy In Plateau-Elderly Gastrointestinal Cancer Patients: A Prospective Randomized Controlled Trial

Gastrointestinal cancer, a common disease with high mortality in the word, happens in Yun-Gui Plateau region of China with high morbidity and mortality. The purpose of this study is using dynamic parameters (provided by the Vigileo FloTrac system) to evaluate the accuracy and effectiveness of goal directed fluid therapy (GDFT) in the perioperative period for plateau-elderly gastrointestinal cancer patients. This prospective, randomized and controlled study was conducted among 88 participants from Yun-Gui Plateau of China, aged over 60 years, undergoing elective radical correction of gastrointestinal cancer. They were randomly allocated into two equal groups: GDFT group, using FloTrac/Vigileo system to obtain blood flow dynamic indices Visual analog scale; routine fluid infusion group (control group), routine fluid infusion according to blood pressure during the surgery. Surveillance indicators contained the following contents: the total fluid infusion volume, the amount of crystalloid and colloid, the urine output, the blood loss volume, the time of first bowel movement after surgery, the postoperative discharge time and the medical care costs. The crystalloid quantity infused in GDFT group was markedly less than that in control group [(1269.32 +/- 332.4) vs (1670.45 +/- 348.8) ml, P < 0.05]. The colloid quantity infused in GDFT group was significantly more than that in control group [(892.64 +/- 413.87) vs (1140.91 +/- 271.36) ml, P < 0.01]. The incidence of pulmonary complications post of the operation in GDFT group was much lower. In GDFT group, the first time of intestinal peristalsis was substantially earlier than that in control group [(81.51 +/- 33.2) vs (107.66 +/- 31.81) min, P < 0.05]. Moreover, the hospitalization days after surgery in GDFT group were much shorter than that in control group. Medical cost in GDFT group was much lower than that in control group. In conclusion, GDFT used in the perioperative period could improve the prognosis of old patients undergoing radical correction of gastrointestinal cancers and reduce the incidence of postoperative complications. On the other hand, patients with this treatment will be happy for cost savings.