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Sarah
Cantrell,
DNP, CRNA
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DNP:
Southern California CSU DNP Consortium, Kaiser Permanente School of Anesthesia
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BSN:
College of St. Scholastica |
Goal-Directed Fluid Therapy and Zero-Balance Fluid Therapy for Colorectal Surgery Patients
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Project
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Abstract: |
To evaluate the compliance of anesthesia providers in using GDFT following an educational training module. Secondary outcomes included length of hospital stay and rate of surgical site infection. Methods: A retrospective chart review was conducted at a single-site acute care hospital. The sample included colorectal surgery cases between December 2021 and May 2022. The final sample size was 20 patients. Descriptive, comparative, and correlational analysis was performed. Results: There was a lack of provider compliance using GDFT. A significant association exists between fluid volume administered and bleeding requiring intraoperative blood transfusion (p = .018). No relationship was found between fluid volume administered and other complications. In particular, the rate of SSI was not associated with GDFT or ZBFT. Post hoc analysis also revealed a significant association between blood product administration and postoperative kidney complications (p = .013). The ASA Classification was found to positively correlate with the length of hospital stay (p = .002). A significant difference exists in the length of stay across four different ASA Classification levels (p = .017). Conclusions: This study found a significant association between fluid volume and bleeding requiring blood transfusion. Anesthesia providers must consider the risks associated with excess crystalloid administration when providing anesthesia to colorectal surgery patients. In particular, anesthesia providers should consider the significant relationship between blood product administration and kidney complications. Additionally, higher ASA Classifications should alert the anesthesia provider to the possibility of prolonged hospitalization in colorectal surgery patients. Future studies can be conducted with a larger sample size to assess associations between fluid administration and SSI, as SSI remains a leading cause of morbidity in colorectal surgery.
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Team Leader: |
Jennifer Thompson, DNP, CRNA |
Team Member(s): |
Rachel McClanahan, DNP, RN, NCSN and Mark Gabot, DNP, CRNA
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Group Member(s): |
Karli Nihei, DNP, CRNA and Susanna Smith, DNP, CRNA |
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