Non-Cochrane · intervention · PM41415860
Perioperative Goal Directed Versus Conventional Fluid Therapy in Head and Neck Free Flap Surgery: A systematic review and meta-analysis.
Shamim Faisal, Khan Adnan A, Sohail Mahnoor, et al. · Sultan Qaboos University medical journal · 2025 · PubMed · doi:10.18295/2075-0528.2918
Findings
Population Adults undergoing head and neck free flap surgery
5 findings
| Goal directed fluid therapy (GDFT) | Conventional fluid therapy (CFT) | Reoperation Postoperative | OR 2.62 [1.01, 6.79] GRADE not reported 2 studies · 156 participants |
| Goal directed fluid therapy (GDFT) | Conventional fluid therapy (CFT) | Flap at risk Postoperative | OR 4.44 [1.35, 14.57] GRADE not reported 3 studies · 262 participants |
| Goal directed fluid therapy (GDFT) | Conventional fluid therapy (CFT) | Flap failure Postoperative | OR 1.88 [0.50, 7.09] GRADE not reported 3 studies · 262 participants |
| Goal directed fluid therapy (GDFT) | Conventional fluid therapy (CFT) | Hospital length of stay (days) Postoperative | MD -2.28 [-4.86, 0.30] GRADE not reported 2 studies · 156 participants |
| Goal directed fluid therapy (GDFT) | Conventional fluid therapy (CFT) | Intensive care unit length of stay (days) Postoperative | MD -0.94 [-1.40, -0.48] GRADE not reported 2 studies · 156 participants |
Included primary studies 3
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Gupta 2021 Prospective analysis of goal-directed fluid therapy vs conventional fluid therapy in perioperative outcome of composite resections of head… PMID:34584284 | 2021 | this review only | not stated | not extracted yet |
| Hand 2016 Intraoperative goal-directed hemodynamic management in free tissue transfer for head and neck cancer. PMID:26829494 | 2016 | this review only | not stated | not extracted yet |
| Kim 2018 Effect of goal-directed haemodynamic therapy in free flap reconstruction for head and neck cancer. PMID:29574681 | 2018 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients undergoing head and neck free flap surgery | Patients undergoing head and neck free flap surgery (n=262) |
| Intervention | Goal-directed fluid therapy (GDFT) | GDFT (n=130) |
| Comparison | Conventional fluid therapy (CFT) | CFT (n=132) |
| Outcomes | Flap failure; flap at risk; ICU length of stay; hospital length of stay; reoperation | Flap failure (3 studies, n=262); flap at risk (3, n=262); reoperation (2, n=156); hospital length of stay (2, n=156); ICU length of stay (2, n=156) |
| Study designs | Prospective randomized controlled trials published after 2010, English full text | 3 RCTs (United States, South Korea, India) |
| Timing | Not specified | Postoperative |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | No | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |