Goal-directed Fluid Therapy
Conditions
Keywords
goal-directed fluid therapy, thoracic surgery, video-assisted, acute lung injury
Brief summary
Perioperative fluid management is a key component of anesthetic management during thoracic surgery. On one hand, fluid restriction could compromise perfusion of vital organs and surgical anastomosis. On the other hand, fluid overload could lead to cardiopulmonary complications, notably pulmonary edema, which carries a high mortality rate. Perioperative fluid management to avoid postpneumonectomy pulmonary edema has been previously reviewed. Therefore, to achieve the balance between preventing fluid overload and optimising organ perfusion, the practical index to guide fluid management, which can predict whether fluid loading will improve haemodynamic conditions in an individual patient, would be very valuable during lung surgery. Perioperative goal-directed fluid therapy (GDFT) is a cornerstone of tissue perfusion and oxygenation, and it can improve surgical outcomes. Respiratory variations of arterial pressure \[i.e. pulse pressure variation (PPV) and systolic pressure variation\] can predict fluid responsiveness in mechanically ventilated patients under various conditions. Therefore, pressure variations are increasingly being advocated for fluid management.This study will discuss the effects of pulse pressure variation(PPV) in different level during anesthesia on patients with oxygenation index and short-term prognosis undergoing video-assisted thoracoscopic surgery for pneumoresection.
Interventions
DEVICEFluid therapy
Conventional therapy group: conventional arterial blood pressure monitoring. Low value of PPV group and high value of PPV group:pulse pressure variation monitoring with arterial blood pressure monitoring.
Sponsors
ZhiHeng Liu
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists physical status I-III; aged 18-60 years old; BMI 18.5 \ 28 kg/m2
Exclusion criteria
* Refused to participate in the experiment, hepatic/renal/cardiac dysfunction, severe valvular disease, frequent arrhythmia, moderate anemia and severe electrolyte disturbance before operation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change from Baseline Oxygenation Index in 48 hours | Before induction, 5 minutes before the end of one-lung ventilation, 48 hours after the operation |
Secondary
| Measure | Time frame |
|---|---|
| The duration of mechanical ventilation | During surgery period |
| Crystalloid administered | During surgery period |
| Colloid administered | During surgery period |
| Blood loss | During surgery period |
| Urine output | During surgery period |
| The duration of surgery | During surgery period |
| Blood pressure | Before the surgery and 48 hours after surgery |
| Leukocyte | Before the surgery and 48 hours after surgery |
| Hematocrit | Before the surgery and 48 hours after surgery |
| Complication until hospital discharge | 1 month after surgery |
| Hospital stay postoperatively | 1 month after surgery |
| Number of patients received vasopressor | During surgery period |
Countries
China
Outcome results
None listed