Fluid Day: Observational Study About Fluid Therapy Administered in Adult Patients Undergoing Surgery in Our Country
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 3,500
- 试验地点
- 1
- 主要终点
- Management of fluid theraphy in the operating room and postoperative care.
研究概览
简要总结
Perioperative fluid therapy has undergone a huge change in clinical practice in recent years. The patterns of replacement and / or restoration of volemia described in the classic anaesthesiology books were supported by weak scientific evidence, and a paradigm shift in perioperative fluid therapy based on aspects such as increased mortality associated with an excessively positive balance of fluids in the perioperative period, evidences related to the non-existence of the third non-anatomical space and the need to preserve the capillary endothelium and its glycocalyx.
On the other hand, advances in technology, through the availability of less invasive monitoring systems, capable of determining dynamic parameters related to blood volume that allow predicting the response to volume management, have provided much more adequate monitoring and simple to guide such intravenous volume restoration.
Following all these changes different guidelines and recommendations have been published in recent years with the intention of clarifying the current evidence and facilitate the correct use of fluid therapy to clinicians, but despite this the fact is that today the investigators still do not have information on how fluid therapy is administered in daily practice, so the section of Hemostasis, Transfusion Medicine and Fluid Therapy of SEDAR, considered it necessary to evaluate the clinical practice of fluid therapy in the perioperative period through the Fluidday study.
详细描述
Background: The administration of fluids in the perioperative period is a routine clinical practice that sometimes underestimates the repercussion of its correct administration.
According to the guidelines of the Spanish Society of Anesthesiology, Resuscitation and Therapy of Pain (SEDAR), the objective of perioperative fluid therapy is to maintain the organism with an optimal state of tissue perfusion and hydration.
This goal is not always easy to carry out. The continuous changes in surgical and anesthetic techniques and the appearance of new fluids and monitoring devices make it difficult for the anesthesiologist to carry out all these changes in his daily clinical practice. For this reason, SEDAR and other international scientific societies have recently published guidelines on the management of fluid therapy in the perioperative period, with the intention of facilitating the decision making of the anesthesiologist in their usual clinical practice based on current evidence. Also adding the recent withdrawal and commercial suspension of a special type of fluid such as Hydroxyethylstarch.
Hypothesis: Fluid therapy in the surgical environment is administered in a protocolized manner and in accordance with the recommendations of the different clinical practice guidelines.
Objectives: To evaluate the management of fluid therapy by anesthesiologists in adult patients during the perioperative period of scheduled and urgent surgery, taking into account the types of fluids administered, the monitoring used and the application of guided therapy protocols by objectives.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 95 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients over 18 years of age surgically treated during the 24 hours of the two-day study of both scheduled and emergency surgery.
排除标准
- •Interventions performed outside the surgical area: complementary examination cabinets.
- •Interventions that do not require the presence of an anesthesiologist.
- •Ophthalmologic surgery
- •Surgery performed with local anesthesia.
结局指标
主要结局
Management of fluid theraphy in the operating room and postoperative care.
时间窗: Two days
The purpose of this study is to evaluate how fluids are administered in the Operating Room and postoperative care. We also collect data on the total amount of fluids administered and the type of fluid administered during the anesthesia procedure and surgery. Type of Crystalloids and total amount in mL * Saline serum 0.9% ....... ml * Lactated Ringer ........ ml * Isofundin ® ........ ml * Plasmalyte® ... ... ml * Glusose 5% ....... ml * Glucose 10% ........ ml * Saline \& Glucose 5% ........ ml Type of Colloids and total amount in mL * HEA 130 / 0.4 ... ... ml * HEA 130 / 0.42 ...... .... ml * Gelatins ... ....... ml * Albumin 5%.......... ml * Albumin 20% ...........ml Method of administration: * Standard * Standard with dosimeters * In pump Use of goal-guided Fluid Therapy protocols * YES * NO Use of Hemocomponents type and total does in mL: * RBC..........mL * Plasma..........................ml * Platelets ..........ml
次要结局
- Vasoactive support(Two days)
- Demographic(Two days)
- Commorbidities(Two days)
- Surgical procedure(Two days)
- Monitorization(Two days)
研究者
Maria José Clara Colomina Soler
Principal Investigator
Hospital Universitari de Bellvitge