Comparison of goal-directed and standard therapy for hemodynamic management in heart transplantation surgery

Abstract

Background: Significant numbers of patients who undergo major surgery experience postoperative problems, the majority of which are preventable. It has been demonstrated that goal-directed therapy, a method for guiding clinicians in administering fluids, vasopressors, and inotropes, reduces mortality and postoperative complications. However, heart transplant patients were not exclusively investigated. This study focused on patients having heart transplant surgery, which compared the effects of goal-directed versus traditional fluid management. Methods: Goal-directed and standard therapy were examined on 74 patients who had received heart transplantation and were randomly divided into two groups.Using Lidco's CO, CI, SVV, and SVR to track progress toward treatment goals, two groups were compared in terms of fluid repositioning and the use of vasoactive medications.We also compared secondary outcomes like AKI, Cardiac dysrhythmia, CVA, ICU length of stay, and 30-day survival. Results: Both groups had similar baseline characteristics. The goal-directed therapy group had less fluid repositioning. AKI, Cardiac dysrhythmia, CVA, ICU stay, and 30-day survival rates did not differ significantly between the groups; however, Conventional patients spent more time in the ICU. Conclusion: Our data showed that the time spent in the intensive care unit after a heart transplant can be cut in half using GDT. Adverse events occurred in both groups with no statistically significant difference. Preoperative goal-directed therapy needs further well-designed and adequately powered studies.