Evidence map›Paper›PMID 34089170›Full record

ArticleInternational urology and nephrology2021

Perioperative outcomes of goal-directed versus conventional fluid therapy in radical cystectomy with enhanced recovery protocol.

Alireza Ghoreifi, Michael F Basin, Saum Ghodoussipour, Soroush T Bazargani, Erfan Amini, Mohammad Aslzare, Jie Cai, Gus Miranda, Shihab Sugeir, Sumeet Bhanvadia and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
5.2field-weighted citation impact, top 4% 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

8 citing papers in PubMed, 26 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

14 authors at 1 institution in 1 country.

Alireza GhoreifiInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Michael F BasinInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Saum GhodoussipourInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Soroush T BazarganiInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Erfan AminiInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Mohammad AslzareInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Jie CaiInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Gus MirandaInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Shihab SugeirDepartment of Anesthesiology, University of Southern California, Los Angeles, CA, USA.
Sumeet BhanvadiaInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Anne K SchuckmanInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Siamak DaneshmandInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA.
Philip LumbDepartment of Anesthesiology, University of Southern California, Los Angeles, CA, USA.
Hooman DjaladatInstitute of Urology, Norris Comprehensive Cancer Center, University of Southern California, USC, 1441 Eastlake Ave. NOR 7416, Los Angeles, CA, 90089, USA. djaladat@med.usc.edu.ORCID http://orcid.org/0000-0002-1984-3556
University of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study is to evaluate the intra/perioperative fluid management and early postoperative outcomes of patients who underwent radical cystectomy with Enhanced Recovery After Surgery protocol, using goal-directed fluid therapy compared to conventional fluid therapy.

methodsThis cohort study included patients who underwent open RC for urothelial bladder carcinoma with intent to cure and Enhanced Recovery After Surgery protocol between May 2012 and August 2019. Patients who had palliative or salvage cystectomy and/or adjunct procedures, as well as those with missing detailed perioperative data were excluded. Data were compared between patients who received goal-directed fluid therapy using stroke volume variation by FloTrac™/Vigileo system (n = 119) and conventional fluid therapy based on the anesthesiologist discretion (n = 192). Primary outcome variable was 90-day complications and secondary outcome measures included in-hospital GFR trend, length of stay, and 90-day readmission.

resultsThe goal-directed fluid therapy group received less total and net intra/perioperative fluid, yet early postoperative glomerular filtration rate trends were similar between both groups (p = 0.7). Estimated blood loss, blood transfusion, index hospital stay, 90-day complication and readmission rates were also comparable between the two groups. Multivariable logistic regression showed no significant association between perioperative fluid management method and 90-day complication rate (OR 1.4, 95% CI 0.8-2.4, p = 0.2).

conclusionStroke volume variation guided goal-directed fluid therapy is safe in radical cystectomy without compromising the renal function. It is associated with less intra- and perioperative fluid infusion; however, no association with hospital stay, 90-day complication or readmission rates were noted.

Indexed as

CystectomyEarly Goal-Directed TherapyEnhanced Recovery After SurgeryAgedCarcinoma, Transitional CellCohort StudiesFemaleFluid TherapyHumansMalePerioperative CareTreatment OutcomeUrinary Bladder NeoplasmsBladder cancerComplicationsCystectomyEnhanced recoveryFluid therapy

Identifiers

PMID34089170
OpenAlexW3164656906

What OpenQuestion holds

Textmetadata
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.