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首页> 外文期刊>Clinics >Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study
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Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study

机译：一项基于胸腔镜肺叶切除术患者单肺通气过程中基于搏动量变化和心脏指数的目标导向流体优化研究

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OBJECTIVES: This pilot study was designed to utilize stroke volume variation and cardiac index to ensure fluid optimization during one-lung ventilation in patients undergoing thoracoscopic lobectomies. METHODS: Eighty patients undergoing thoracoscopic lobectomy were randomized into either a goal-directed therapy group or a control group. In the goal-directed therapy group, the stroke volume variation was controlled at 10%±1%, and the cardiac index was controlled at a minimum of 2.5 L.min-1.m-2. In the control group, the MAP was maintained at between 65 mm Hg and 90 mm Hg, heart rate was maintained at between 60 BPM and 100 BPM, and urinary output was greater than 0.5 mL/kg-1/h-1. The hemodynamic variables, arterial blood gas analyses, total administered fluid volume and side effects were recorded. RESULTS: The PaO2/FiO2-ratio before the end of one-lung ventilation in the goal-directed therapy group was significantly higher than that of the control group, but there were no differences between the goal-directed therapy group and the control group for the PaO2/FiO2-ratio or other arterial blood gas analysis indices prior to anesthesia. The extubation time was significantly earlier in the goal-directed therapy group, but there was no difference in the length of hospital stay. Patients in the control group had greater urine volumes, and they were given greater colloid and overall fluid volumes. Nausea and vomiting were significantly reduced in the goal-directed therapy group. CONCLUSION: The results of this study demonstrated that an optimization protocol, based on stroke volume variation and cardiac index obtained with a FloTrac/Vigileo device, increased the PaO2/FiO2-ratio and reduced the overall fluid volume, intubation time and postoperative complications (nausea and vomiting) in thoracic surgery patients requiring one-lung ventilation.
机译：目的：本实验研究旨在利用卒中体积变化和心脏指数来确保胸腔镜肺叶切除术患者单肺通气期间的体液优化。方法：将80例行胸腔镜肺叶切除术的患者随机分为目标导向治疗组或对照组。在目标导向治疗组中，卒中量变化控制在10％±1％，心脏指数控制在最小2.5 L.min-1.m-2。在对照组中，MAP维持在65 mm Hg至90 mm Hg之间，心率维持在60 BPM至100 BPM之间，尿量大于0.5 mL / kg-1 / h-1。记录血流动力学变量，动脉血气分析，总给药液量和副作用。结果：目标导向治疗组单肺通气结束前的PaO2 / FiO2-比值明显高于对照组，但目标导向治疗组与对照组之间无差异。麻醉前的PaO2 / FiO2-比值或其他动脉血气分析指标。目标导向治疗组拔管时间明显较早，但住院时间无差异。对照组患者的尿液量更大，他们的胶体和总体液量也更大。目标导向治疗组的恶心和呕吐明显减少。结论：本研究结果表明，基于FloTrac / Vigileo装置获得的卒中量变化和心脏指数的优化方案可增加PaO2 / FiO2-比值，并减少总体液量，插管时间和术后并发症（恶心）和呕吐）在需要单肺通气的胸外科患者中。

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