The effect of goal-directed fluid therapy on endothelial glycocalyx and short-term postoperative recovery quality in older patients undergoing laparoscopic hernia or gallbladder surgery: a randomized controlled double-blind clinical study
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background This study aimed to observe the effects of intraoperative goal-directed fluid therapy on postoperative recovery in older patients undergoing laparoscopic hernia or gallbladder surgery. Methods A total of 60 older patients were randomly assigned to the control group (C group) and the goal- directed fluid therapy group (G group). The primary outcome was the plasma concentration of syndecan-1. The secondary outcomes were the plasma concentrations of tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1); mean arterial pressure; heart rate; regional cerebral oxygen saturation; intraoperative dopamine dosage; QoR-15 scale score; hematocrit; and postoperative adverse events. Results Compared with the C group, the G group showed decreased plasma concentrations of ICAM-1 at the end of surgery and 24 h after surgery ( P = 0.010 and 0.005, respectively), decreased plasma concentrations of syndecan-1 at the end of surgery ( P = 0.049), more significantly decreased plasma concentrations of VCAM-1 at the end of surgery and 24 h after surgery ( P < 0.001 and P = 0.017, respectively), and decreased plasma concentrations of IL-1β at the end of surgery and 24 h after surgery ( P = 0.009 and 0.008, respectively). The C group showed increased plasma concentration of TNF-α at the end of surgery and 24 h after surgery compared with those before surgery ( P = 0.003 and 0.023, respectively). Compared with the C group, the QoR-15 scores were higher at 24, 48, and 72 h after surgery ( P = 0.001, 0.001, and 0.005, respectively) in the treatment group. Conclusion Intraoperative goal-directed fluid therapy in non-critically ill older patients may alleviate endothelial glycocalyx degradation with a lower incidence of adverse events. Clinical Trial Registration http://www.chictr.org.cn/ , Chinese Clinical Trial Registry ChiCTR2500097999.
Source: Frontiers in Medicine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7221776665