Table 2.
Meta-analysis of organ-specific morbidity between the GDFTdyn and standard fluid therapy group
| Events | Studies, n | Patients (GDFT), n | Events (GDFT), n | Patients (control), n | Events (control), n | OR | 95%CI | P value | References |
|---|---|---|---|---|---|---|---|---|---|
| Neurological events | |||||||||
| Stroke | |||||||||
| Analysis 2 | 7 | 292 | 3 | 286 | 10 | 0.38 | (0.13, 1.13) | 0.08 | [13, 29, 34, 35, 43, 44, 49] |
| Cardiovascular events | |||||||||
| Arrhythmia | |||||||||
| Analysis 1 | 2 | 57 | 4 | 56 | 6 | 0.59 | (0.16, 2.25) | 0.44 | [33, 36] |
| Analysis 2 | 14 | 513 | 37 | 504 | 57 | 0.58 | (0.37, 0.92) | 0.02* | [13, 21, 23, 24, 27, 29, 30, 32, 34, 35, 43, 44, 48, 49] |
| Myocardial infarction | |||||||||
| Analysis 2 | 10 | 423 | 8 | 416 | 23 | 0.35 | (0.16, 0.76) | 0.008* | [13, 20, 21, 23, 24, 30, 34, 35, 48, 49] |
| Heart failure/cardiovascular dysfunction | |||||||||
| Analysis 1 | 2 | 57 | 0 | 56 | 2 | 0.17 | (0.01, 3.73) | 0.26 | [33, 36] |
| Analysis 2 | 9 | 403 | 7 | 400 | 25 | 0.31 | (0.14, 0.67) | 0.003* | [13, 29, 32, 34, 35, 43, 45, 48, 49] |
| Pulmonary events | |||||||||
| ALI/ARDS | |||||||||
| Analysis 1 | 2 | 57 | 2 | 56 | 5 | 0.4 | (0.09, 1.86) | 0.24 | [33, 36] |
| Analysis 2 | 3 | 170 | 1 | 170 | 10 | 0.13 | (0.02, 0.74) | 0.02* | [13, 43, 45] |
| Pneumonia | |||||||||
| Analysis 1 | 2 | 57 | 6 | 56 | 8 | 0.69 | (0.22, 2.15) | 0.53 | [33, 36] |
| Analysis 2 | 10 | 423 | 26 | 420 | 58 | 0.4 | (0.24, 0.65) | 0.0002* | [13, 23, 29, 30, 34, 35, 43, 45, 47, 49] |
| Pulmonary embolism | |||||||||
| Analysis 1 | 1 | 17 | 0 | 16 | 1 | 0.3 | (0.01, 7.79) | 0.47 | [33] |
| Analysis 2 | 6 | 257 | 0 | 253 | 2 | 0.31 | (0.03, 3.04) | 0.31 | [13, 29, 30, 34, 35, 44] |
| Abdominal events | |||||||||
| GIT bleeding | |||||||||
| Analysis 1 | 3 | 98 | 5 | 97 | 5 | 0.98 | (0.27, 3.57) | 0.98 | [22, 33, 36] |
| Analysis 2 | 3 | 116 | 1 | 116 | 2 | 0.66 | (0.11, 4.03) | 0.65 | [13, 35, 43] |
| GIT obstruction | |||||||||
| Analysis 1 | 1 | 17 | 0 | 16 | 1 | 0.3 | (0.01, 7.79) | 0.47 | [33] |
| Analysis 2 | 5 | 170 | 4 | 170 | 5 | 0.83 | (0.24, 2.79) | 0.76 | [13, 23, 30, 35, 48] |
| Renal events | |||||||||
| AKI | |||||||||
| Analysis 1 | 3 | 190 | 7 | 192 | 14 | 0.49 | (0.19, 1.23) | 0.13 | [22, 31, 36] |
| Analysis 2 | 10 | 444 | 16 | 444 | 25 | 0.6 | (0.31, 1.17) | 0.14 | [13, 17, 23, 24, 30, 34, 43–45, 47] |
| Renal failure with dialysis | |||||||||
| Analysis 1 | 2 | 81 | 2 | 81 | 0 | 3.08 | (0.31, 30.19) | 0.34 | [22, 36] |
| Analysis 2 | 7 | 380 | 7 | 381 | 8 | 0.87 | (0.32, 2.39) | 0.79 | [13, 17, 18, 20, 27, 34, 45] |
Analysis 1: goal-directed fluid therapy based on dynamic parameters (GDFTdyn) alone versus standard fluid therapy; analysis 2: GDFTdyn with other optimization goals versus standard fluid therapy
AKI acute kidney injury, ALI/ARDS acute lung injury/acute respiratory distress syndrome, CI confidential interval, GDFT goal-directed fluid therapy, GDFTdyn, GIT gastrointestinal, OR odds ratio
*P < 0.05