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Intraoperative goal-directed hemodynamic management in free tissue transfer for head and neck cancer.
Hand, William R; Stoll, William D; McEvoy, Matthew D; McSwain, Julie R; Sealy, Clark D; Skoner, Judith M; Hornig, Joshua D; Tennant, Paul A; Wolf, Bethany; Day, Terry A.
Afiliación
  • Hand WR; Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina.
  • Stoll WD; Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina.
  • McEvoy MD; Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee.
  • McSwain JR; Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina.
  • Sealy CD; Medical University of South Carolina, Charleston, South Carolina.
  • Skoner JM; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
  • Hornig JD; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
  • Tennant PA; Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, Kentucky.
  • Wolf B; Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina.
  • Day TA; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Head Neck ; 38 Suppl 1: E1974-80, 2016 04.
Article en En | MEDLINE | ID: mdl-26829494
BACKGROUND: The purpose of this study was to determine the effect of algorithmic physiologic management on patients undergoing head and neck free tissue transfer and reconstruction. METHODS: Ninety-four adult patients were randomized to treatment and control groups. The blood pressure of the control group was managed consistent with contemporary standards. The treatment group was managed using an algorithm based on blood pressure and calculated physiologic values derived from arterial waveform analysis. Primary outcome was intensive care unit (ICU) length of stay. RESULTS: ICU length of stay was decreased in the treatment group (33.7 vs 58.3 hours; p = .026). The complication rate was not increased in the treatment group. CONCLUSION: The goal-directed hemodynamic management algorithm decreased the ICU length of stay. Judicious use of vasoactive drugs and goal-directed fluid administration has a role in improving perioperative outcomes for patients undergoing head and neck free tissue transfer. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1974-E1980, 2016.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Tisulares Libres / Tratamiento Precoz Dirigido por Objetivos / Neoplasias de Cabeza y Cuello Tipo de estudio: Clinical_trials / Guideline Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Tisulares Libres / Tratamiento Precoz Dirigido por Objetivos / Neoplasias de Cabeza y Cuello Tipo de estudio: Clinical_trials / Guideline Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos