The Effect of Fluid Management by SVV of FloTrac/ Vigileo™ Monitoring on Postoperative Recovery in Bowel Resection
Condition: Bowel Resection
Study type: Interventional

Summary: 
      During an enterectomy, especially in an open surgery, large amounts of fluid are administered
      in consideration of the patient's fasted state, maintaining blood pressure during surgery and
      potential third space loss. However, it has recently been reported that excessive fluid
      administration during surgery is actually detrimental to patients' prognoses. In fact,
      several reports have suggested that compared to limited fluid administration, excessive fluid
      administration increased the length of stay or the chances of complications. Thus,
      goal-directed fluid optimization is required during surgery because only a proper amount of
      fluid (neither limited nor excessive) administration can minimize postoperative complications
      and enhance prognosis. In general, the amount of fluid administered is determined with regard
      to the patient's volume status, including a comprehensive assessment of vital signs such as
      the pulse rate and blood pressure, and urine volume. However, this method has limitations in
      that it is an inadequate indicator of the actual intravascular volume of a patient to
      determine and administer the proper amount of fluid. Recently, new methods of measuring
      volume status that are less invasive and more accurate have been introduced. These methods
      include stroke volume variation (SVV) that monitors changes in arterial pressure waveform
      amplitudes with regard to breathing patterns. This is an effective method of monitoring fluid
      responsiveness after placing a catheter via a radial artery puncture. The stroke output is
      dependent on the preload, afterload, and cardiac contractility. The cardiac output is
      determined by multiplying the stroke output and heart rate. SVV indicates the difference in
      stroke output within one breathing cycle. A direct or indirect measurement of stroke output
      is required, which can be performed by analyzing arterial pressure waveforms via a FloTrac
      Sensor (Edwards Lifesciences, USA) monitor. SVV is known to have a high fluid responsiveness
      even during open surgeries, yet there is practically no research data on its effect in
      patients' postoperative recovery and prognosis in comparison to the traditional methods of
      fluid administration. Therefore, the investigators will apply SVV via a FloTrac/ Vigileo™
      monitor on patients undergoing bowel resection to determine whether it better assists proper
      fluid administration compared to the traditional method of fluid administration by examining
      the patients' postoperative prognosis such as bowel movement recovery and length of stay.
    


Intervention name(s): Conventional arterial blood pressure monitoring; Stroke volume variation monitoring with arterial blood pressure monitoring
Intervention type(s): Device; Device
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other