Table 2 Characteristics of GDT/control subgroups hemodynamic protocol
| Â | 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 | |