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. 2013 Feb 22:13:5.
doi: 10.1186/1471-2253-13-5.

Goal-directed fluid therapy- a survey of anaesthetists in the UK, USA, Australia and New Zealand

Sanket Srinivasa  1 , Arman Kahokehr, Mattias Soop, Matthew Taylor, Andrew G Hill
Affiliations

Goal-directed fluid therapy- a survey of anaesthetists in the UK, USA, Australia and New Zealand

Sanket Srinivasa et al. BMC Anesthesiol. .

Abstract

Background: Goal-directed fluid therapy (GDFT) has been shown to reduce complications and hospital length of stay following major surgery. However, there has been no assessment regarding its use in clinical practice.

Methods: An electronic survey was administered to randomly selected anaesthetists from the United Kingdom (UK, n = 2000) and the United States of America (USA, n = 2000), and 500 anaesthetists from Australia/New Zealand (AUS/NZ). Preferences, clinical use and attitudes towards GDFT were investigated. Results were collated to examine regional differences.

Results: The response rates from the UK (n = 708) and AUS/NZ (n = 180) were 35%, and 36% respectively. The response rate from the USA was very low (n = 178; 9%). GDFT use was significantly more common in the UK than in AUS/NZ (p < 0.01). The Oesophageal Doppler Monitor was the most preferred instrument in the UK (n = 362; h76%) with no clear preferences in other regions. GDFT was most commonly utilised in major abdominal surgery and for patients with significant comorbidities. The commonest reasons stated for not using GDFT were either lack of availability of monitoring tools (AUS/NZ: 57 (70%); UK: 94 (64%)) or a lack of experience with instruments (AUS/NZ: 43 (53%); UK: 51 (35%)). A subset of respondents (AUS/NZ: 22(27%); UK: 45 (30%)) felt GDFT provided no perceived benefit. Enthusiasm towards the use of GDFT in the absence of existing barriers was high.

Conclusion: Several hypotheses were generated regarding important differences in the use of GDFT between anaesthetists from the UK and AUS/NZ. There is significant interest in utilising GDFT in clinical practice and existing barriers should be addressed.

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Figures

Figure 1
Figure 1
Do you use Goal-directed fluid therapy? (Columns from left to right respectively: Always; Sometimes; Never). Always/Sometimes: USA vs. UK, p = 0.36; USA vs. NZ, p < 0.01; UK vs. NZ, p < 0.01.
Figure 2
Figure 2
Would you like to use Goal-Directed Fluid Therapy? (Columns from left to right respectively: Yes/No/Undecided).
See this image and copyright information in PMC

References

    1. Lobo DN, Macafee DAL, Allison SP. How perioperative fluid balance influences postoperative outcomes. Best Prac Res Clin Anaesthesiol. 2006;20(3):439–55. doi: 10.1016/j.bpa.2006.03.004. - DOI - PubMed
    1. Chappell D, Jacob M, Hofmann-Kiefer K, Conzen P, Rehm M. A rational approach to perioperative fluid management. Anesthesiology. 2008;109(4):723–40. doi: 10.1097/ALN.0b013e3181863117. - DOI - PubMed
    1. Zargar-Shoshtari K, Hill AG. Optimization of perioperative care for colonic surgery: a review of the evidence. ANZ J Surg. 2008;78(1–2):13–23. - PubMed
    1. Zargar-Shoshtari K, Connolly AB, Israel LH, Hill AG. Fast-track surgery may reduce complications following major colonic surgery. Dis Col Rect. 2008;51(11):1633–40. doi: 10.1007/s10350-008-9386-1. - DOI - PubMed
    1. Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248(2):189–98. doi: 10.1097/SLA.0b013e31817f2c1a. - DOI - PubMed

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