Introduction of oesophageal doppler-guided fluid management in a laparoscopic colorectal surgery enhanced recovery programme: An audit of effect on patient outcome

Abstract

Morbidity after colorectal surgery can be reduced with intraoperative oesophageal Doppler monitor (ODM) guided fluid therapy. We audited the effect of introducing ODM-guided fluid therapy in enhanced recovery laparoscopic colorectal surgery. ODM group (n=40) outcomes (toleration of diet, Post Operative Morbidity Survery (POMS) score, complications) were compared to matched patients (n=40) who had the same surgery using a conventional approach to fluid management. Mean (SD) time to tolerate diet was shorter in the ODM group (2.3 (1.6) days vs 3.8 (2.4) days, p = 0.003). The ODM group had a lower mean (SD) POMS score on post-operative day 1 (2 (1.4) vs 4 (1.1), p = 0.001), fewer postoperative complications (14 patients vs 20, p=0.009) and a lower rate of unplanned critical care area admission (1 vs 6, p= 0.001). Introduction of intraoperative ODM-guided stroke volume optimization was associated with improved outcomes in patients undergoing enhanced recovery laparoscopic colorectal surgery.