• J Hillova Mannova, Z Silhart, P Sevcik, and A Prokes.
• Department of Anaesthesiology and Intensive Care, Masaryk University, Czech Republic. hillovajitka@seznam.cz
• Bratisl Med J. 2013 Jan 1;114(2):78-83.

BackgroundAAA repair is associated with high rate of mortality and morbidity. Oesophageal Doppler (OED) can offer a less invasive cost-effective tool for intraoperative monitoring of haemodynamic changes. The aim of the study was to confirm the benefits of haemodynamic optimisation in patients undergoing AAA repair using OED monitoring. We assumed that haemodynamic parameters of patients with OED would be better optimised; they would probably get more fluids during the operation, and their ICU and hospital stay would be shorter as a result of having fewer postoperative complications and lower mortality.MethodsSeventy patients (Doppler group) who underwent AAA operation in 2003-2008 were matched with 70 patients (control group) operated on AAA in 1998-2002. OED was used to estimate the cardiac output, its variations and fluid management. The administered fluids, length of ICU and hospital stay, frequency of postoperative complications and mortality were compared in Doppler and control groups (Mann-Whitney test, Fisher's exact test).ResultsNo statistically significant difference was found in preoperative parameters. The Doppler group was administered significantly more crystalloids (p<0.001), colloids (p<0.001), sum-up of fluids (4000 ml vs. 3000 ml; p<0.001) in the perioperative period. The Doppler group had a lower incidence of major serious complications (8 vs. 21; p=0.034) and shorter ICU (4 vs. 6 days; p<0.001) and hospital stay (10 vs. 11 days; p=0.012).ConclusionsThe haemodynamic monitoring by oesophageal Doppler can improve the outcome of patients with AAA repair (fewer major complications, shorter ICU and hospital stay) (Tab. 4, Fig. 4, Ref. 25).

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