Evidence map›Paper›PMID 31360460›Full record

ArticleAnnals of medicine and surgery (2012)2019

Goal directed fluid therapy for major liver resection: A multicentre randomized controlled trial.

Laurence Weinberg, Damian Ianno, Leonid Churilov, Steven Mcguigan, Lois Mackley, Jonathan Banting, Shi Hong Shen, Bernhard Riedel, Mehrdad Nikfarjam, Chris Christophi

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of medicine and surgery (2012), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 5 pooled it
2.7field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Laurence WeinbergDirector of Anesthesia, Austin Hospital; and A/Professor, Department of Surgery, Austin Health, The University of Melbourne, Victoria, Australia.
Damian IannoDepartment of Anesthesia, Austin Health, Victoria, Australia.
Leonid ChurilovStatistics and Decision Analysis Academic Platform, The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Victoria, Australia.
Steven McguiganDepartment of Anesthesia, Austin Health, Victoria, Australia.
Lois MackleyDepartment of Anesthesia, Austin Hospital, Heidelberg, Victoria, Australia.
Jonathan BantingDepartment of Anesthesia, Austin Hospital, Heidelberg, Victoria, Australia.
Shi Hong ShenDepartment of Anesthesia, Peter MacCallum Cancer Hospital, Victoria, Australia.
Bernhard RiedelDepartment of Anesthesia, Peter MacCallum Cancer Hospital, Victoria, Australia.
Mehrdad NikfarjamDepartment of Surgery, Austin Hospital, The University of Melbourne, Victoria, Australia.
Chris ChristophiDepartment of Surgery, Austin Hospital, The University of Melbourne, Victoria, Australia.
The University of Melbourne · AUAustin Health · AUAustin Hospital · AUPeter MacCallum Cancer Centre · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effect a restrictive goal directed therapy (GDT) fluid protocol combined with an enhanced recovery after surgery (ERAS) programme on hospital stay for patients undergoing major liver resection is unknown.

methodsWe conducted a multicentre randomized controlled pilot trial evaluating whether a patient-specific, surgery-specific intraoperative restrictive fluid optimization algorithm would improve duration of hospital stay and reduce perioperative fluid related complications.

resultsForty-eight participants were enrolled. The median (IQR) length of hospital stay was 7.0 days (7.0:8.0) days in the restrictive fluid optimization algorithm group (Restrict group) vs. 8.0 days (6.0:10.0) in the conventional care group (Conventional group) (Incidence rate ratio 0.85; 95% Confidence Interval 0.71:1.1; p = 0.17). No statistically significant difference in expected number of complications per patient between groups was identified (IRR 0.85; 95%CI: 0.45-1.60; p = 0.60). Patients in the Restrict group had lower intraoperative fluid balances: 808 mL (571:1565) vs. 1345 mL (900:1983) (p = 0.04) and received a lower volume of fluid per kg/hour intraoperatively: 4.3 mL/kg/hr (2.6:5.8) vs. 6.0 mL/kg/hr (4.2:7.6); p = 0.03. No significant differences in the proportion of patients who received vasoactive drugs intraoperatively (p = 0.56) was observed.

conclusionIn high-volume hepatobiliary surgical units, the addition of a fluid restrictive intraoperative cardiac output-guided algorithm, combined with a standard ERAS protocol did not significantly reduce length of hospital stay or fluid related complications. Our findings are hypothesis-generating and a larger confirmatory study may be justified.

Indexed as

Cardiac outputComplicationsFluid therapyHemodynamicsHepatectomyMonitoringSurgery

Identifiers

PMID31360460
PMCPMC6642079
OpenAlexW2960839806

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.