Meta-analysis Of Effect Of Goal-directed Fluid Therapy On The Outcomes Following Orthopedic Surgery

Objective: Goal directed fluid therapy(GDHT)has been used in clinical fluid management for decades,but its effect on the outcomes of orthopedic surgery is inconsistent,The purpose of Meta-analysis is to evaluate the effect of GDFT on the outcomes following orthopedic surgery,and to provide evidence-based medical evidence for clinical perioperative fluid therapy.Methods: This study searched from Chinese and English databases such as Zhiwang,Wanfang,VIP,SCI,SpringerLink,PubMed,Embase,The Cochrane Library,EBSCO to collect the randomized controlled studies comparing The GDFT with conventional fluid therapy in orthopedic surgery.The retrieval date is from January2000 to January 2020.The target literatures were collected according to the inclusion and exclusion criteria after evaluating the quality of the literature.Collected the required data and carried on the relevant statistical analysis through the Rev Man5.4software.Main outcome measures were postoperative complications,secondary indicators: length of stay,mortality,infusion volume and so on.Result: A total of 13 RCT literatures included 2098 patients which included The GDFT(n=1042)and conventional fluid treatment group(n=1056).Compared with the control group,the patients in the Goal-directed fluid therapy group had fewer postoperative complications,postoperative wound infection,postoperative nausea and vomiting,shorter hospital stay,and improved blood lactic acid and cerebral oxygen saturation after operation(P<0.05).There was no significant difference in heart,lung,kidney and other important organs,postoperative cognitive dysfunction and postoperative mortality between the two groups.(P>0.05).Conclusion: The application of GDFT to guide the fluid management during orthopedic surgery can make the hemodynamics more stable,improve the tissue perfusion of patients,ensure the balance of oxygen supply,reduce the incidence of postoperative complications and shorten the length of stay in orthopedic surgery,but there is no statistical significance in important organ function and postoperative mortality.