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Báo cáo y học: "Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study. | Benes et al. Critical Care 2010 14 R118 http ccforum.eom content 14 3 R118 c CRITICAL CARE RESEARCH Open Access Intraoperative fluid optimization using stroke volume variation in high risk surgical patients results of prospective randomized study Jan Benes Ivan Chytra Pavel Altmann Marek Hluchy Eduard Kasal Roman Svitak Richard Pradl and Martin Stepan Abstract Introduction Stroke volume variation SVV is a good and easily obtainable predictor of fluid responsiveness which can be used to guide fluid therapy in mechanically ventilated patients. During major abdominal surgery inappropriate fluid management may result in occult organ hypoperfusion or fluid overload in patients with compromised cardiovascular reserves and thus increase postoperative morbidity. The aim of our study was to evaluate the influence of SVV guided fluid optimization on organ functions and postoperative morbidity in high risk patients undergoing major abdominal surgery. Methods Patients undergoing elective intraabdominal surgery were randomly assigned to a Control group n 60 with routine intraoperative care and a Vigileo group n 60 where fluid management was guided by SVV Vigileo FloTrac system . The aim was to maintain the SVV below 10 using colloid boluses of 3 ml kg. The laboratory parameters of organ hypoperfusion in perioperative period the number of infectious and organ complications on day 30 after the operation and the hospital and ICU length of stay and mortality were evaluated. The local ethics committee approved the study. Results The patients in the Vigileo group received more colloid 1425 ml 1000-1500 vs. 1000 ml 540-1250 P 0.0028 intraoperatively and a lower number of hypotensive events were observed 2 1-2 Vigileo vs. 3.5 2-6 in Control P 0.0001 . Lactate levels at the end of surgery were lower in Vigileo 1.78 0.83 mmol l vs. 2.25 1.12 mmol l P 0.0252 . Fewer Vigileo patients developed complications 18 30 vs. 35 58.3 patients P 0.0033 and the overall number of complications was .