The effect of goal-directed fluid therapy on endothelial glycocalyx and short-term postoperative recovery quality in older patients undergoing laparoscopic hernia or gallbladder surgery: a randomized controlled double-blind clinical study.
- 1Affiliated Hospital, North Sichuan Medical College, Nanchong, China.
- 2Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital), Nanchong, China.
Abstract
This study aimed to observe the effects of intraoperative goal-directed fluid therapy on postoperative recovery in older patients undergoing laparoscopic hernia or gallbladder surgery. A total of 60 older patients were randomly assigned to the control group (C group) and the goal- directed fluid therapy group (G group). The primary outcome was the plasma concentration of syndecan-1. The secondary outcomes were the plasma concentrations of tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1); mean arterial pressure; heart rate; regional cerebral oxygen saturation; intraoperative dopamine dosage; QoR-15 scale score; hematocrit; and postoperative adverse events. Compared with the C group, the G group showed decreased plasma concentrations of ICAM-1 at the end of surgery and 24 h after surgery (P = 0.010 and 0.005, respectively), decreased plasma concentrations of syndecan-1 at the end of surgery (P = 0.049), more significantly decreased plasma concentrations of VCAM-1 at the end of surgery and 24 h after surgery (P < 0.001 and P = 0.017, respectively), and decreased plasma concentrations of IL-1β at the end of surgery and 24 h after surgery (P = 0.009 and 0.008, respectively). The C group showed increased plasma concentration of TNF-α at the end of surgery and 24 h after surgery compared with those before surgery (P = 0.003 and 0.023, respectively). Compared with the C group, the QoR-15 scores were higher at 24, 48, and 72 h after surgery (P = 0.001, 0.001, and 0.005, respectively) in the treatment group. Intraoperative goal-directed fluid therapy in non-critically ill older patients may alleviate endothelial glycocalyx degradation with a lower incidence of adverse events. http://www.chictr.org.cn/, Chinese Clinical Trial Registry ChiCTR2500097999.
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BibTeX
@article{wei2026effect,
title = {{The effect of goal-directed fluid therapy on endothelial glycocalyx and short-term postoperative recovery quality in older patients undergoing laparoscopic hernia or gallbladder surgery: a randomized controlled double-blind clinical study.}},
author = {Qinxian Wei and Man Zhou and Wenji Xu and Jiaxin Wan and Wuchang Fu and Fangjun Wang},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1922109},
url = {https://europepmc.org/article/MED/42952895},
note = {CC BY},
}
RIS
TY - JOUR
TI - The effect of goal-directed fluid therapy on endothelial glycocalyx and short-term postoperative recovery quality in older patients undergoing laparoscopic hernia or gallbladder surgery: a randomized controlled double-blind clinical study.
AU - Qinxian Wei
AU - Man Zhou
AU - Wenji Xu
AU - Jiaxin Wan
AU - Wuchang Fu
AU - Fangjun Wang
PY - 2026
DA - 2026/10/14
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1922109
UR - https://europepmc.org/article/MED/42952895
AB - This study aimed to observe the effects of intraoperative goal-directed fluid therapy on postoperative recovery in older patients undergoing laparoscopic hernia or gallbladder surgery. A total of 60 older patients were randomly assigned to the control group (C group) and the goal- directed fluid therapy group (G group). The primary outcome was the plasma concentration of syndecan-1. The secondary outcomes were the plasma concentrations of tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1); mean arterial pressure; heart rate; regional cerebral oxygen saturation; intraoperative dopamine dosage; QoR-15 scale score; hematocrit; and postoperative adverse events. Compared with the C group, the G group showed decreased plasma concentrations of ICAM-1 at the end of surgery and 24 h after surgery (P = 0.010 and 0.005, respectively), decreased plasma concentrations of syndecan-1 at the end of surgery (P = 0.049), more significantly decreased plasma concentrations of VCAM-1 at the end of surgery and 24 h after surgery (P < 0.001 and P = 0.017, respectively), and decreased plasma concentrations of IL-1β at the end of surgery and 24 h after surgery (P = 0.009 and 0.008, respectively). The C group showed increased plasma concentration of TNF-α at the end of surgery and 24 h after surgery compared with those before surgery (P = 0.003 and 0.023, respectively). Compared with the C group, the QoR-15 scores were higher at 24, 48, and 72 h after surgery (P = 0.001, 0.001, and 0.005, respectively) in the treatment group. Intraoperative goal-directed fluid therapy in non-critically ill older patients may alleviate endothelial glycocalyx degradation with a lower incidence of adverse events. http://www.chictr.org.cn/, Chinese Clinical Trial Registry ChiCTR2500097999.
SN - 2296-858X
ER -