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Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes
Scoliosis surgery is a challenge for the entire team in terms of safety, and its accomplishment requires the utilization of advanced monitoring technologies. A prospective, single centre, non-randomised controlled cohort study, was designed to assess the efficacy of protocolised intraoperative haemo...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453073/ https://www.ncbi.nlm.nih.gov/pubmed/37628370 http://dx.doi.org/10.3390/children10081371 |
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author | Miegoń, Jakub Zacha, Sławomir Skonieczna-Żydecka, Karolina Wiczk-Bratkowska, Agata Andrzejewska, Agata Jarosz, Konrad Deptuła-Jarosz, Monika Biernawska, Jowita |
author_facet | Miegoń, Jakub Zacha, Sławomir Skonieczna-Żydecka, Karolina Wiczk-Bratkowska, Agata Andrzejewska, Agata Jarosz, Konrad Deptuła-Jarosz, Monika Biernawska, Jowita |
author_sort | Miegoń, Jakub |
collection | PubMed |
description | Scoliosis surgery is a challenge for the entire team in terms of safety, and its accomplishment requires the utilization of advanced monitoring technologies. A prospective, single centre, non-randomised controlled cohort study, was designed to assess the efficacy of protocolised intraoperative haemodynamic monitoring and goal-directed therapy in relation to patient outcomes following posterior fusion surgery for adolescent idiopathic scoliosis (AIS). The control group (n = 35, mean age: 15 years) received standard blood pressure management during the surgical procedure, whereas the intervention group (n = 35, mean age: 14 years) underwent minimally invasive haemodynamic monitoring. Arterial pulse contour analysis (APCO) devices were employed, along with goal-directed therapy protocol centered on achieving target mean arterial pressure and stroke volume. This was facilitated through the application of crystalloid boluses, ephedrine, and noradrenaline. The intervention group was subjected to a comprehensive protocol following Enhanced Recovery After Surgery (ERAS) principles. Remarkably, the intervention group exhibited notable advantages (p < 0.05), including reduced hospital stay durations (median 7 days vs. 10), shorter episodes of hypotension (mean arterial pressure < 60 mmHg—median 8 vs. 40 min), lesser declines in postoperative haemoglobin levels (−2.36 g/dl vs. −3.83 g/dl), and quicker extubation times. These compelling findings strongly imply that the integration of targeted interventions during the intraoperative care of AIS patients undergoing posterior fusion enhance a set of treatment outcomes. |
format | Online Article Text |
id | pubmed-10453073 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104530732023-08-26 Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes Miegoń, Jakub Zacha, Sławomir Skonieczna-Żydecka, Karolina Wiczk-Bratkowska, Agata Andrzejewska, Agata Jarosz, Konrad Deptuła-Jarosz, Monika Biernawska, Jowita Children (Basel) Article Scoliosis surgery is a challenge for the entire team in terms of safety, and its accomplishment requires the utilization of advanced monitoring technologies. A prospective, single centre, non-randomised controlled cohort study, was designed to assess the efficacy of protocolised intraoperative haemodynamic monitoring and goal-directed therapy in relation to patient outcomes following posterior fusion surgery for adolescent idiopathic scoliosis (AIS). The control group (n = 35, mean age: 15 years) received standard blood pressure management during the surgical procedure, whereas the intervention group (n = 35, mean age: 14 years) underwent minimally invasive haemodynamic monitoring. Arterial pulse contour analysis (APCO) devices were employed, along with goal-directed therapy protocol centered on achieving target mean arterial pressure and stroke volume. This was facilitated through the application of crystalloid boluses, ephedrine, and noradrenaline. The intervention group was subjected to a comprehensive protocol following Enhanced Recovery After Surgery (ERAS) principles. Remarkably, the intervention group exhibited notable advantages (p < 0.05), including reduced hospital stay durations (median 7 days vs. 10), shorter episodes of hypotension (mean arterial pressure < 60 mmHg—median 8 vs. 40 min), lesser declines in postoperative haemoglobin levels (−2.36 g/dl vs. −3.83 g/dl), and quicker extubation times. These compelling findings strongly imply that the integration of targeted interventions during the intraoperative care of AIS patients undergoing posterior fusion enhance a set of treatment outcomes. MDPI 2023-08-10 /pmc/articles/PMC10453073/ /pubmed/37628370 http://dx.doi.org/10.3390/children10081371 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Miegoń, Jakub Zacha, Sławomir Skonieczna-Żydecka, Karolina Wiczk-Bratkowska, Agata Andrzejewska, Agata Jarosz, Konrad Deptuła-Jarosz, Monika Biernawska, Jowita Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title | Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title_full | Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title_fullStr | Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title_full_unstemmed | Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title_short | Optimising Intraoperative Fluid Management in Patients Treated with Adolescent Idiopathic Scoliosis—A Novel Strategy for Improving Outcomes |
title_sort | optimising intraoperative fluid management in patients treated with adolescent idiopathic scoliosis—a novel strategy for improving outcomes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453073/ https://www.ncbi.nlm.nih.gov/pubmed/37628370 http://dx.doi.org/10.3390/children10081371 |
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