The intraoperative hemodynamic control through functional parameters in free flap reconstruction in head and neck surgery: our initial expertise

Background: The role of intravenous uids during surgical proce-dures is debated. Actually, many studies show the utility of manag-ing hemodynamic control in operating room through non-invasive or minimally invasive cardiac output monitoring. The intraoperative uids administration could be guided by functional hemodynamic parameters to avoid hypervolemia during free aps reconstruction in ENT surgery.Materials and method: In our ENT department we have used both functional hemodynamic parameters through vigileo® monitoring (vigileo group) and anaesthesiological recommendations (standard group) during major ENT surgical procedures with free ap recon-struction. We describe our data in terms of intraoperative hemody-namics management and rate of complications in both groups.Results: We have done a retrospective examination about 17 pa-tient’s undergone surgical procedures in head and neck departments with free aps reconstruction from November 2012 to February 2014. We had only one major complication (venous anastomosis failure) in the vigileo group. We’ve found that there are no statistical differences in amount of volume uids infused (vigileo 477, 7 ml/h standard group 490, 2 ml/h) between study groups. We have found a systematically use of vasoactive drugs in continuous infusion only in vigileo group.Discussion: Hemodynamic optimization has been related to a better outcome in surgical procedures with an improvement in microcirculation anastomosis. The role of functional hemodynamics parameters in ENT surgery with free aps reconstruction is promis-ing. Further assessments in large randomized trial are necessary.