Application value of goal-directed fluid therapy with ERAS in patients undergoing radical lung cancer surgery

To explore the application value of goal-directed fluid therapy (GDFT) in the enhanced recovery after surgery (ERAS) of patients undergoing radical lung cancer surgery (RLCS).

A total of 74 patients undergoing elective RLCS based on the enhance recovery after surgery (ERAS) concept in the HanDan Central Hospital between December 2016 and December 2019 were enrolled and assigned to a group treated by regular conventional liquids (regular group, n=34) and a group treated by goal-directed fluid (GDFT group, n=40) according to the fluid infusion scheme. The two groups were compared in intraoperative fluid inflow and outflow, hemodynamic indexes at 30 min (T0) before operation, 4 h (T1) and 24 h (T2) after operation, postoperative complications, postoperative recovery, inflammatory factors at 1 day (d 0) before operation, and at 1 day (d 1) and 7 days (d 3) after operation, as well as for postoperative life quality.

Crystalloid fluid input, fluid infusion, and urine output of the GDFT group were all significantly less than those of the regular group (all P<0.05), and the GDFT group showed significantly lower fluctuations of MAP, cardiac index, and stroke volume (SV) than the regular group (all P<0.05). Additionally, the GDFT group showed a significantly lower overall complication rate and experienced notably earlier time to flatus and getting out-of-bed time and notably shorter hospitalization time than the regular group (all P<0.05). Moreover, the GDFT group presented with less fluctuation of IL-10, IL-6, and TNF-α levels and experienced notably higher life quality scores than the regular group.

GDFT is beneficial to the rapid recovery of patients after RLCS, because it can exert a positive effect on maintaining the stability of hemodynamic indexes and reducing inflammation and postoperative complications.