Goal-Directed Fluid Therapy Using Stroke Volume Variation Does Not Result in Pulmonary Fluid Overload in Thoracic Surgery Requiring One-Lung Ventilation
Joint Authors
Hasbach, Ted
Haas, Sebastian
Reuter, Daniel A.
Trepte, Constantin
Goetz, Alwin E.
Eichhorn, Volker
Kutup, Asad
Source
Critical Care Research and Practice
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-06-21
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
Goal-directed fluid therapy (GDT) guided by functional parameters of preload, such as stroke volume variation (SVV), seems to optimize hemodynamics and possibly improves clinical outcome.
However, this strategy is believed to be rather fluid aggressive, and, furthermore, during surgery requiring thoracotomy, the ability of SVV to predict volume responsiveness has raised some controversy.
So far it is not known whether GDT is associated with pulmonary fluid overload and a deleterious reduction in pulmonary function in thoracic surgery requiring one-lung-ventilation (OLV).
Therefore, we assessed the perioperative course of extravascular lung water index (EVLWI) and paO2/FiO2-ratio during and after thoracic surgery requiring lateral thoracotomy and OLV to evaluate the hypothesis that fluid therapy guided by SVV results in pulmonary fluid overload.
Methods.
A total of 27 patients (group T) were enrolled in this prospective study with 11 patients undergoing lung surgery (group L) and 16 patients undergoing esophagectomy (group E).
Goal-directed fluid management was guided by SVV (SVV < 10%).
Measurements were performed directly after induction of anesthesia (baseline—BL), 15 minutes after implementation OLV (OLVimpl15), and 15 minutes after termination of OLV (OLVterm15).
In addition, postoperative measurements were performed at 6 (6postop), 12 (12postop), and 24 (24postop) hours after surgery.
EVLWI was measured at all predefined steps.
The paO2/FiO2-ratio was determined at each point during mechanical ventilation (group L: BL-OLVterm15; group E: BL-24postop).
Results.
In all patients (group T), there was no significant change (P>0.05) in EVLWI during the observation period (BL: 7.8 ± 2.5, 24postop: 8.1 ± 2.4 mL/kg).
A subgroup analysis for group L and group E also did not reveal significant changes of EVLWI.
The paO2/FiO2-ratio decreased significantly during the observation period (group L: BL: 462 ± 140, OLVterm15: 338 ± 112 mmHg; group E: BL: 389 ± 101, 24postop: 303 ± 74 mmHg) but remained >300 mmHg except during OLV.
Conclusions.
SVV-guided fluid management in thoracic surgery requiring lateral thoracotomy and one-lung ventilation does not result in pulmonary fluid overload.
Although oxygenation was reduced, pulmonary function remained within a clinically acceptable range.
American Psychological Association (APA)
Haas, Sebastian& Eichhorn, Volker& Hasbach, Ted& Trepte, Constantin& Kutup, Asad& Goetz, Alwin E.…[et al.]. 2012. Goal-Directed Fluid Therapy Using Stroke Volume Variation Does Not Result in Pulmonary Fluid Overload in Thoracic Surgery Requiring One-Lung Ventilation. Critical Care Research and Practice،Vol. 2012, no. 2012, pp.1-8.
https://search.emarefa.net/detail/BIM-490596
Modern Language Association (MLA)
Haas, Sebastian…[et al.]. Goal-Directed Fluid Therapy Using Stroke Volume Variation Does Not Result in Pulmonary Fluid Overload in Thoracic Surgery Requiring One-Lung Ventilation. Critical Care Research and Practice No. 2012 (2012), pp.1-8.
https://search.emarefa.net/detail/BIM-490596
American Medical Association (AMA)
Haas, Sebastian& Eichhorn, Volker& Hasbach, Ted& Trepte, Constantin& Kutup, Asad& Goetz, Alwin E.…[et al.]. Goal-Directed Fluid Therapy Using Stroke Volume Variation Does Not Result in Pulmonary Fluid Overload in Thoracic Surgery Requiring One-Lung Ventilation. Critical Care Research and Practice. 2012. Vol. 2012, no. 2012, pp.1-8.
https://search.emarefa.net/detail/BIM-490596
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-490596