Background: Sufficient tissue oxygen tension may reduce the risk of postoperative wound infections. Supplemental administration of crystalloids increases subcutaneous oxygen tension (Po). Colloids remain longer in the intravascular system and might therefore increase Po even more than crystalloids. Therefore, we tested the hypothesis that goal-directed colloid administration increases the perioperative Po more compared with crystalloid administration.
Methods: We randomly assigned 80 patients undergoing elective open abdominal surgery to receive fluid boluses of hydroxyethyl starch (HES) or lactated Ringer's (LR) solution guided by oesophageal Doppler. Intraoperative Po was measured in the upper arm. After operation, we measured the Po in the upper arm and in the surgical wound.
Results: Forty patients were enrolled in each group. Patients in the colloid group received HES solution 750 ml (500; 1000) and LR solution 1500 ml (1000; 2000). Patients in the crystalloid group received LR solution 2825 ml (2000; 3960). The goal-directed administration of colloids did not improve intraoperative Po in the arm compared with crystalloid administration (11.4 kPa [9.0; 16.6] vs 11.2 kPa [8.6; 15.1], respectively; P=0.58). Postoperative arm Po was 8.1 kPa (6.5; 9.6) in the colloid group and 7.3 kPa (5.7; 9.1) in the crystalloid group (P=0.11). Postoperative surgical wound Po was 10.7 kPa (8.6; 13.4) in the colloid group and 10.1 kPa (8.1; 12.7) in the crystalloid group (P=0.68).
Conclusions: Goal-directed colloid administration did not increase Po compared with goal-directed crystalloid administration in patients undergoing open abdominal surgery.
Clinical Trial Registration: NCT00517127.
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