Background: Non-invasive goal directed fluid therapy during deceased donor renal transplant\n(CRT) may reduce the incidence of delayed graft function. Plethysmograph Variability Index (PVI)\nhas been shown to predict fluid responsiveness during surgery. This pilot study evaluated the feasibility\nof goal directed fluid administration protocol based upon PVI studying the incidence of\ndelayed graft function (DGF) in renal transplant recipients. Methods: Twenty patients underwent\nprimary CRT. The Control group received intravenous fluid (IVF) at a calculated constant rate. The\nTreatment group received a baseline IVF infusion throughout the surgery. PVI values greater than\n13% were treated with 250 ml boluses of IVF. Primary end point was DGF; total IVF administration\nand urinary biomarker NGAL levels were secondary endpoints. Results: Treatment group at every\ntime point received significantly less IVF. There was no significant difference in incidence of DGF\nbetween the groups. 2 patients in the Control group and 6 in the Treatment group developed DGF.\nNGAL was not associated with the group assignment or total IVF given (p < 0.2). Conclusions: The\neffectiveness of goal directed fluid therapy with non-invasive dynamic parameters has not been\nvalidated in renal transplant surgery and larger prospective studies are needed to determine its\nutility in renal transplantation.
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