surgery-and-ENT-2016_scientifictracks-abstracts

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Volume 6, Issue 6(Suppl) Surgery Curr Res
ISSN: 2161-1076, an open access journal
Page 25
Notes:
Surgery & ENT 2016
November 07-08, 2016
conferenceseries.com
Surgery & ENT November 07-08, 2016 Alicante, Spain
5th International Conference and Exhibition on
Microcirculatory effects of goal directed fluid therapy in colorectal surgery: Amechanistic cohort study
Juan C Gomez-Izquierdo, Jin Qian, Mohamed Badawy, Liane Feldman and Gabriele Baldini
McGill University, Canada
Goal directed fluid therapy (GDFT) optimizes oxygen delivery by guiding fluid administration using cardiac output analysis. It
has demonstrated to enhance the bowel function and to decrease the incidence of postoperative primary ileus (PPOI) in some
clinical trials. Bowel perfusion is critical for bowel motility; thus, an improvement of the splanchnic blood flow might explain the
effects of GDFT on bowel function. Nowadays, it is feasible to evaluate tissue microcirculation at the patient’s bedside with side
stream dark field (SDF) technology. A cohort of 24 patients undergoing colorectal surgery in an enhanced recovery program at the
Montreal General Hospital and receiving either intraoperative GDFT (eight patients) or standard fluid therapy (16 patients) was
followed and microcirculatory measurements were done using the MicroScan, MicroVision Medical at seven different perioperative
time points. Bowel function and incidence of PPOI were assessed. PPOI was found in three patients in GDFT and three patients
in the standard fluid therapy exposure (p=0.643). The overall perioperative proportion of perfused vessels (PPV) was higher in the
GDFT exposure (p=0.023); and specifically on postoperative (POP) day three (p=0.032). There was no significant difference in other
microcirculation outcomes. To conclude, GDFT improves the PPV, a key factor for oxygen extraction in the tissues, effect that was
sustained until postoperative day three. GDFT also demonstrated a more stable oxygen delivery throughout the surgery. Nevertheless,
these physiological effects did not translate into a better postoperative bowel function in GDFT compared to standard fluid therapy.
Biography
Juan C Gomez-Izquierdo is currently pursuing PhD in Experimental Surgery at McGill University. He has completed a Research Fellowship in Department of Anesthesia
at the same university and obtaining Medical Residency training at Jewish General Hospital in Montreal. He has completed his Medical degree at Pontificia Universidad
Javeriana. He has co-authored different papers in perioperative care and goal directed fluid therapy, including meta-analyses, randomized controlled trials, cohort studies
and three book chapters. His area of interest includes epidemiology, evidence-based medicine and hospital care.
Juan C Gomez-Izquierdo et al., Surgery Curr Res 2016, 6:6(Suppl)