To compare intraoperative goal directed fluid therapy by trans-oesophageal Doppler vis-a-vis FloTrac TM in patients undergoing living related renal transplantation-a prospective randomised controlled study.
Kaur, U., et al.Indian Journal of Anaesthesia 2020; 64(Suppl 4): S220-S226.
Aims
The aim of this study was to compare two types of intraoperative goal directed fluid therapy (GDFT) in patients undergoing living donor kidney transplantation: one based on corrected flow time (CFT), measured using trans oesophageal doppler (TED), and another based on stroke volume variation (SVV), assessed using FloTrac™ .
Interventions
Participants were randomised to either the TED group or the FloTrac™ group.
Participants
60 patients undergoing living donor kidney transplantation.
Outcomes
The primary endpoints were the assessment of total fluid and number of fluid boluses administered intraoperatively. The secondary endpoints were the assessment of allograft function as well as any postoperative complications resulting from fluid overload.
Follow-up
90 days
CET Conclusions
This small single-centre study investigated the use of two different types of goal-directed fluid therapy during living donor kidney transplantation. Recipients were randomised to use of trans-oesophageal doppler or FloTrac (stroke volume variation) to guide fluid management intraoperatively. No significant differences were found in fluid volume, operative complications or post-operative outcomes between the groups. Overall, the study is well designed and reported, although it is not entirely clear why block randomization was required and the protocol was registered retrospectively. The biggest risk is of type II error due to small sample size, but from the data presented here it appears that either method of fluid management can be used effectively.
Data analysis
Per protocol analysis
Trial registration
CTRI/2017/07/009159