Fluids vs. Dobutamine for Oxygen Delivery in High-Risk Surgery
Author Information
Author(s): Suzana M Lobo, Francisco R Lobo, Carlos A Polachini, Daniela S Patini, Adriana E Yamamoto, Neymar E de Oliveira, Patricia Serrano, Helder S Sanches, Marco A Spegiorin, Marcio M Queiroz, Antonio C Christiano Jr, Elisangela F Savieiro, Paula A Alvarez, Silvia P Teixeira, Geni S Cunrath
Primary Institution: Division of Critical Care Medicine, Departments of Internal Medicine, Anesthesiology and Surgery, Medical School – FUNFARME and Hospital de Base, São José do Rio Preto, São Paulo, Brazil
Hypothesis
The study aimed to investigate the effect of DO2I optimization with fluids or with fluids and dobutamine on the 60-day hospital mortality and incidence of complications.
Conclusion
Using dobutamine for hemodynamic optimization leads to better outcomes compared to fluids alone in high-risk surgical patients.
Supporting Evidence
- Cardiovascular complications were significantly more frequent in the volume group (52%) than in the dobutamine group (16%).
- The 60-day mortality rates were 28% in the volume group and 8% in the dobutamine group.
- More patients in the dobutamine group achieved the target DO2I compared to the volume group.
Takeaway
In high-risk surgery patients, giving dobutamine helps them recover better than just giving fluids.
Methodology
A randomized controlled trial was performed in 50 high-risk patients undergoing major elective surgery, comparing fluids alone to fluids and dobutamine.
Potential Biases
The volume group received more packed red blood cells, which could affect outcomes.
Limitations
Blinding was not possible, and there was a small imbalance in comorbidities between groups.
Participant Demographics
Patients were elderly with coexistent pathologies, undergoing major elective surgery.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI = 1.22–8.60
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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