ĐÁNH GIÁ HIỆU QUẢ LIỆU PHÁP ĐIỀU TRỊ SỚM THEO MỤC TIÊU TRÊN BỆNH NHÂN PHẪU THUẬT BẮC CẦU MẠCH VÀNH

Abstract

Purpose: Early goal-directed therapy (EGDT) using the FloTrac system reportedly improved postoperative outcomes among high-risk patients undergoing non-cardiac surgery. This study aim to evaluate the FloTrac/EV1000 platform’s efficacy in postoperative cardiac surgery outcomes. Patients and Methods: Ninety - four adults undergoing coronary artery bypass graft (CABG) were randomized to the EGDT and the Control group. The Control group was treated with standard protocol to achieve the following goals: mean blood pressure 65–90 mmHg; central venous pressure 8–12 mmHg; urine output ≥0.5 mL · kg−1 · h−1; oxygen saturation >95%; and hematocrit 26–30%. The EGDT group was treated to reach similar goals using information from the FloTrac/EV1000 monitor. The targets were stroke volume variation < 13%; stroke volume index 33–65 mL · beat⁻¹ · m⁻²; cardiac index 2.2–4.0 L·min⁻¹ · m⁻²; and systemic vascular resistance index 1600–2500 dynes · s · cm^-5 · m^-2. Results: The EGDT group had shorter hospital stay and mechanical ventilation time. The number of cases requiring cardiopymonary bypass support in the EGDT group was significantly less than in the control group (p < 0.001). Reduced the complication rate and the number of patients needing to use Dobutamine after surgery in the EGDT group was also decreased (p < 0.001). Conclusion: EGDT using FloTrac/EV1000 can improve postoperative CABG outcomes.