Abstract

Impact of a Goal Directed Fluid Therapy on Length of Hospital Stay and Costs of Hepatobiliary Pancreatic Surgery. A Prospective Observational Study

Background: The effectiveness of Goal Directed Fluid Therapy (GDFT) algorithms in improving postoperative outcomes has been extensively suggested in literature. Nevertheless, there is a lack of strong evidence regarding both the clinical impact and the cost-effectiveness of the GDFT protocols. The aim of this study is to evaluate the costs of patients undergoing hepatobiliopancreatic surgery when a GDFT fluid-therapy protocol is applied.
Methods: All consecutive ASA I-III patients undergoing hepatobiliopancreatic surgery were included in this prospective observational study. Depending on device availability patients were handled either by standard fluid treatment (Standard group) or fluid therapy guided by Vigileo monitor derived hemodynamic variables (Vigileo GDFT group). Postoperative length of stay and economic costs were analyzed.
Results: One hundred fortyseven consecutive patients were included, 71 in the Vigileo GDFT group and 76 in the Standard group. The total hospital length of stay was 13(9-20) days for the Vigileo GDFT group and 14(8-21) days for the Standard group (p=0.58); no statistically significant differences between the two groups emerged regarding costs and postoperative complications.
Conclusions: Application of a GDFT algorithm did not have impact on the total length of hospital stay and the global costs, which were mainly influenced by the number of complications.


Author(s):

Naccarato A, Tribuzi S, Marco C, Valerio M, Giulia T, Marco C, Silvia G, Gian LG, Claudia C* and Ester F



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