Our Summary

The purpose of this research paper is to figure out whether it’s better to use a specific, goal-directed approach for managing fluids during chest surgery, rather than a moderate, one-size-fits-all approach. The researchers found that while the current recommended method is to use a moderate amount of fluids, a goal-directed approach could be more reliable, especially for patients who are at a higher risk. Numerous studies have looked at the effects of this method in general anesthesia, but these studies have their limitations and there are fewer studies for chest surgery. However, from the evidence available, the goal-directed approach seems to be generally linked with fewer complications after surgery. It could be a useful tool in making decisions about how to optimize the volume of fluids, when to give them, and when to use drugs that affect blood vessels.

FAQs

  1. What is the current recommendation for fluid management in thoracic surgery?
  2. What is ‘Goal-Directed Therapy’ and how can it be more reliable in thoracic surgery?
  3. Does ‘Goal-Directed Therapy’ reduce postoperative complications in thoracic surgery?

Doctor’s Tip

A doctor might tell a patient undergoing thoracic surgery to follow their post-operative fluid management plan closely, as it can help reduce the risk of complications and improve recovery. It’s important to stay well-hydrated and follow any specific guidelines provided by your healthcare team.

Suitable For

Patients who are typically recommended for thoracic surgery include those with lung cancer, esophageal cancer, mediastinal tumors, pleural diseases, empyema, lung abscess, and severe infections of the lung or chest cavity. Additionally, patients with severe or persistent symptoms such as chest pain, shortness of breath, or coughing up blood may also be recommended for thoracic surgery. Patients with conditions that have not responded to other treatments, such as medications or less invasive procedures, may also be candidates for thoracic surgery.

Timeline

Before thoracic surgery:

  1. Consultation with a thoracic surgeon to discuss the need for surgery and potential risks and benefits.
  2. Preoperative testing such as blood work, imaging studies, and possibly a pulmonary function test.
  3. Meeting with an anesthesiologist to discuss anesthesia options and potential complications.
  4. Preoperative instructions such as fasting before surgery and stopping certain medications.
  5. Admission to the hospital or surgical center on the day of surgery.

After thoracic surgery:

  1. Recovery in the post-anesthesia care unit (PACU) for monitoring and pain management.
  2. Transfer to a hospital room for further monitoring and recovery.
  3. Physical therapy to help with breathing exercises and mobility.
  4. Pain management through medications and other techniques.
  5. Monitoring for potential complications such as infection, bleeding, or breathing problems.
  6. Discharge from the hospital with instructions for home care and follow-up appointments with the surgeon.

What to Ask Your Doctor

  1. What is the goal of fluid management in thoracic surgery?
  2. What are the potential risks and benefits of goal-directed therapy in thoracic anesthesia compared to a moderate fluid regimen?
  3. How will my individual health condition and surgical procedure impact the decision for goal-directed therapy?
  4. What monitoring tools or techniques will be used to guide fluid management during my surgery?
  5. Are there any specific factors or conditions that would make me a good candidate for goal-directed therapy in thoracic surgery?
  6. How will the decision for fluid management be made during the surgery and will adjustments be made as needed?
  7. What are the potential complications or side effects associated with goal-directed therapy in thoracic surgery?
  8. How will the effectiveness of the fluid management approach be evaluated after the surgery?
  9. Are there any alternative or complementary approaches to goal-directed therapy that could be considered in my case?
  10. What are the expected outcomes or benefits of using goal-directed therapy in thoracic surgery for me personally?

Reference

Authors: Şentürk M, Bingül ES, Turhan Ö. Journal: Curr Opin Anaesthesiol. 2022 Feb 1;35(1):89-95. doi: 10.1097/ACO.0000000000001083. PMID: 34889800