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Table 2 Characteristics of GDT/control subgroups hemodynamic protocol

From: Association between perioperative fluid administration and postoperative outcomes: a 20-year systematic review and a meta-analysis of randomized goal-directed trials in major visceral/noncardiac surgery

  Group Bolus
(amount)
Bolus
(type)
Vasopressor
(type, % of pt.)
Hemodynamic goal Transfusion
(% of pt.)
Hemodynamic
monitor
Conway [41] GDT 3 ml/kg Voluven® NA SV > 10% after FC
FTC < 0.35 s
NA ODP (TECO2®)
Control NA NA NA NA NA Standard
monitoring
Wakeling [42] GDT 250 ml Haemaccel®
Gelofusine ®
NA Repeated FC until
SV response > 10% or CVP > 3 mmHg
NA ODP—CardioQ
Control Standard care Standard care NA CVP 12- 15 mmHg
Oxygen Delivery Index > 600 ml/min/m2
NA ODP—CardioQ
Pearse [30] GDT 250 ml Gelofusine ® Dopexamine (all) SV response > 10% for 20 min
CVP increase > 2 mmHg for 20 min
NA LiDCOplus
Control 250 ml Gelofusine ® NA CVP increase of at least 2 mmHg
for 20 min
NA Standard
monitoring
Lobo [26] GDT 1000 ml
500 ml
Crystalloids
Gelatine
Dobutamina; 8% Oxygen Delivery Index < 600 ml/min/m2
PAOP < 16 mmHg
44% PAC
Control 1000 ml
500 ml
Crystalloids
Gelatine
Dobutamina; 100% Oxygen Delivery Index < 600 ml/min/m2
PAOP < 16 mmHg
48% PAC
Donati [31] GDT NA Colloids UN
(250–1000 ml)
Dobutamine; 44.1% O2ER < 27%
MAP > 80 mm Hg
UO > 0.5 ml/kg/h
CVP 8–12 cmH20
NA O2ER
Control NA Colloids UN
(250–1000 ml)
Dobutamine; 4.5% MAP > 80 mm Hg
UO > 0.5 ml/kg/h
CVP 8–12 cmH20
NA Standard
monitoring
Benes [25] GDT 3 ml/kg Voluven ®
Tetraspan ®
Norepinephrine; 13.7%
Dobutamine; 1.9%
SVV < 10%
CI/CVP changes after FC
NA Vigileo/FT
Control NA Colloids UN
Crystalloids UN
Norepinephrine, 11.1%
Dobutamine, 0%
MAP > 65 mm Hg
UO > 0.5 ml/kg/h
CVP 8–115 cmH20
NA Standard
monitoring
Mayer [43] GDT 500 ml (first)
250 ml (further)
Cristalloyds UN
Colloids UN
Norepinephrine (%NA)
Dobutamine (%NA)
CI < 2.5 L/min/m2
MAP > 65 mm Hg
SVI > / < 35 ml/min/m2
NA Vigileo/FT
Control 500 ml (first)
250 ml (further)
Cristalloyds UN
Colloids UN
NA MAP 65–90 mm Hg
UO > 0.5 ml/kg/h
CVP 8–12 cmH20
NA Standard
monitoring
Brandstrup [32] GDT 200 ml Voluven ® Different vasopressors (%NA) Repeated FC until
SV response > 10%
NA ODP—CardioQ
Control 200 ml Voluven ® Different vasopressors (%NA) MAP > 60 mmHg
Hematocrit 25 and 35%
NA ODP—CardioQ
Salzwedel [27] GDT NA NA Norepinephrine, 32.9%
Phenylephrine,0%
Ephedrine, 13.9%
Dobutamine, 41.8%
PPV < 10%
CI > 2.5 L/min/m2
MAP > 65 mmHg
NA ProAQT
Control NA NA Norepinephrine, 3.5%
Phenylephrine, 4.9%
Ephedrine, 9.8%
Dobutamine, 0%
AD NA Standard
monitoring
McKenny [44] GDT 3 ml/kg Voluven ® NA Repeated FC until
SV response > 10%
8; 16% ODP
Control Standard care AD NA AD 8; 16% ODP
Scheeren [28] GDT 200 ml Voluven ® Norepinephrine (% NA) Repeated FC if SVV > 10%
Repeated FC until
SV response > 10%
NA Vigileo/FT
Control Standard care Colloids UN
Crystalloids UN
Norepinephrine (% NA) Standard care NA Vigileo/FT
Srinivasa [45] GDT 7 ml/kg FC first
3 ml/kg other
Gelofusine® 83.7% (type UN) FTC 0.35 – 0.4 s
SV after FC > 10%
13, 35% ODP—CardioQ
Control Up to 1500 ml PlasmaLyte®
Up to 1500 ml Gelofusine®
91.8% (type UN) Standard care 12, 32% ODP—CardioQ
Pearse [19] GDT 250 ml Colloids UN Bolus 82.2%
Infusion 28.1%
MAP 60–100 mmHg
SV optimization
NA LiDCOrapid
Control Standard care Standard care Bolus 74.8%
Infusion 30%
Standard care NA NA
Phan [46] GDT 250 ml Voluven®
Gelofusine®
4% human albumin
NA Hypotension
SVI < 35 ml/m2
FTc < 0.3 s
None ODP
Control Blood loss replacement
Hypotension not responsive to vasopressor
Ringer lactate
UN Colloids
NA none None Standard
monitoring
Ackland [47] GDT NA Gelatine Vasopressor 18 (19%) Oxygen Delivery Index pre-postoperative
Repeated FC until SV response > 10%
25 (26%) LiDCOplus
Control NA Gelatine Vasopressor 21 (23%) ScVO2 > 65%
MAP > 60 mm Hg
UO > 0.5 mL/kg/h
Oxygen Delivery Index
16 (17%) LiDCOplus
Correa-Gallego C GDT 1:1 blood loss replacement
Albumin infusion
(type NA) 58% SVV to a value ≤ 2 SD from baseline 6% EV1000
Control 1:1 blood loss replacement
6 ml/kg/hr Crystalloids
(type NA) 58% Hypotension systolic BP < 90 mmHg,
Urine output < 25 ml/h
2% EV1000
Weinberg GDT 250 mL Hartmann or PlasmaLyte
4% or 20% albumin
NA SVV < 20%
MAP < 20% of baseline
CI > 2 L/kg/m2
NA EV1000
Control AD Hartmann or PlasmaLyte
4% or 20% albumin
NA AD NA EV1000
Gomez-Izquierdo [49] GDT 200 mL Voluven® NA SV optimization NA ODP
Control AD Ringer Lactate
Voluven®
NA AD NA ODP
Wu [50] GDT 50 ml Colloids (UN) Ephedrine, phenylephrine;
dobutamine
SVV < 12% NA Vigileo/FT
Control 50 ml Colloids (UN) Ephedrine, phenylephrine CVP > 8 mmHg
MAP < 80% of baseline value
NA Vigileo/FT
Zhao [33] GDT 200 mL Different Colloids MAP/CI guided SVV < 15%
MAP ≥ 65 mmHg
CI > 2.5 L/min/m2
NA Vigileo/FT
Control AD AD NA NA NA Standard
monitoring
Weinberg [29] GDT 250 mL AD with Crystalloids
or Colloids
MAP/CI guided SVV < 20%/15%
MAP of 20% basal
CI > 2.2 L/min/m2
NA EV1000
Control AD AD with Crystalloids
or Colloids
Discretion of the anesthetist CVP > 8 mmHg during dissection and hepatic transection stages NA EV1000
  1. NA, data not available; UN, unspecified; AD; at the discretion of the care-giving anesthesiologist; GDT, patients’ subgroup receiving goal-directed therapy; mL, milliliters; SV, stroke volume; FTC, corrected flow time; ODP, esophgeal doppler probe; O2ER, oxygen extraction; MAP, mean arterial pressure; UO, urine output; CVP, central venous pressure; SVV, stroke volume variation; FC, fluid challenge; CI; cardiac index; PAC, pulmonary artery catheter; PAOP; pulmonary artery occlusion pressure
  2. Vigileo/FT; Vigileo/Flow Track: Edwards Lifesciences, Irvine, CA, USA
  3. CardioQ: DP12 probe; Pharmaco NZ, Auckland, New Zealand
  4. ProAQT: PULSION Medical Systems SE, Munich, Germany
  5. LiDCOrapid/ LiDCOplus: LiDCO, Cambridge, UK