Influence of goal-directed fluid therapy guided by the Vigileo-FloTrac(TM) system on intestinal mucosal barrier function in elderly patients with colorectal cancer

Vigileo-FloTrac™系统指导的目标导向液体治疗对老年结直肠癌患者肠黏膜屏障功能的影响

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Abstract

INTRODUCTION: Colorectal cancer is a clinically common malignancy arising in the digestive tract. AIM: To evaluate the influence of goal-directed fluid therapy (GDFT) guided by the Vigileo-FloTrac(TM) system on intestinal mucosal barrier function in elderly patients with colorectal cancer. MATERIAL AND METHODS: A prospective study was conducted on 106 elderly patients with colorectal cancer. They were divided into control and research groups (n = 53) using a random number table, and subjected to conventional fluid therapy and Vigileo-FloTrac(TM) system-guided GDFT, respectively. Their intraoperative indicators, postoperative indicators, and changes of haemodynamics, oxygen metabolism, intestinal mucosal barrier function at different time points, and incidence rates of complications were compared. RESULTS: Compared with the control group, the intraoperative urine volume, colloid fluid volume, crystalloid fluid volume, and total infusion volume were lower, and the first postoperative exhaust time, first postoperative feeding time, and hospital stay were shorter in the research group (p < 0.05). At T(1) and T(2), mean artery pressure, heart rate, central venous pressure, oxygen consumption, oxygen delivery, and oxygen extraction ratio in the research group were lower than in the control group, but all of them first rose and then fell in the 2 groups (p < 0.05). On the 3(rd) day after surgery, the levels of serum endothelin, diamine oxidase and D-lactate declined in both groups, and the decline was more obvious in the research group (p < 0.05). CONCLUSIONS: GDFT guided by the Vigileo-FloTrac(TM) system is beneficial to the prognosis of patients by effectively decreasing fluid infusion.

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