Effect of goal-directed fluid therapy on brain tumor resection: A systematic review and meta-analysis
Received date: 2022-08-25
Online published: 2023-09-27
Objective To systematically evaluate the effect of goal-directed fluid therapy (GDFT) on brain tumor resection. Methods Relevant articles reporting the application of GDFT to brain tumor resection published from the inception to April 2022 were searched in online databases, including the PubMed, Embase, Cochrane Library, Web of Science, VIP database, CNKI, WanFang database, and Chinese Biomedical Database (CBM). Eligible studies were screened according to the inclusion and exclusion criteria. After quality evaluation and extraction of relevant data, RevMan5.3 software and Stata SE16.0 software were used for meta-analysis. Results A total of 17 eligible randomized controlled trials (RCTs) involving 962 patients were included. Meta-analysis results showed that at the end of surgery, patients in GDFT group had increased cardiac index (CI) (MD=0.45; 95%CI: 0.36, 0.55; P<0.01), mean arterial pressure (MAP) (MD=6.14; 95%CI: 4.85, 7.44; P<0.01), and jugular bulb mixed oxygen saturation (SjvO2) (1 hour after incision of the dura: MD=4.77; 95%CI: 2.58, 6.96; P<0.01; at the end of surgery: MD=4.42; 95%CI: 1.21, 7.62; P=0.007), but significantly lower blood lactate (Lac) (MD=-0.57; 95%CI: -0.77, -0.37; P<0.01) than those of regular fluid group. The postoperative National Institute of Health stroke (NIHSS) score decreased [24 h after surgery: MD=-2.95; 95%CI: -3.85, -2.05; P<0.01), and the postoperative Mini-mental State Examination (MMSE) score increased (1 day after surgery: MD= 1.12; 95%CI: 0.26, 1.99; P=0.01; 3 days after surgery: MD=1.40; 95%CI: 0.75, 2.05; P<0.01) in patients of GDFT group than those of regular fluid group. Conclusion GDFT can maintain hemodynamic stability, improve tissue perfusion, sustain oxygen supply-demand balance, and facilitate postoperative recovery in patients undergoing brain tumor resection.
Youling Hou , Yi Li , Hongyu Guan , Hongxia Luo . Effect of goal-directed fluid therapy on brain tumor resection: A systematic review and meta-analysis[J]. Clinical Focus, 2023 , 38(8) : 686 -693 . DOI: 10.3969/j.issn.1004-583X.2023.08.002
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