scholarly journals The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery

2021 ◽  
Vol 10 (9) ◽  
pp. 1857
Author(s):  
Ki-Young Lee ◽  
Young-Chul Yoo ◽  
Jin-Sun Cho ◽  
Wootaek Lee ◽  
Ji-Young Kim ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Rating Scale ◽  
Fluid Management ◽  
Bowel Function ◽  
Colon Resection ◽  
Control Group ◽  
Anesthetic Care ◽  
Volume Variation ◽  
Function Recovery

Stroke volume variation (SVV) has been used to predict fluid responsiveness; however, it remains unclear whether goal-directed fluid therapy using SVV contributes to bowel function recovery in abdominal surgery. This prospective randomized controlled trial aimed to compare bowel movement recovery in patients undergoing colon resection surgery between groups using traditional or SVV-based methods for intravenous fluid management. We collected data between March 2015 and July 2017. Bowel function recovery was analyzed based on the gas-passing time, sips of water time, and soft diet (SD) time. Finally, we analyzed data from 60 patients. There was no significant between-group difference in the patients’ characteristics. Compared with the control group (n = 30), the SVV group (n = 30) had a significantly higher colloid volume and lower crystalloid volume. Moreover, the gas-passing time (77.8 vs. 85.3 h, p = 0.034) and SD time (67.6 vs. 85.1 h, p < 0.001) were significantly faster in the SVV group than in the control group. Compared with the control group, the SVV group showed significantly lower scores of pain on a numeric rating scale and morphine equivalent doses during post-anesthetic care, at 24 postoperative hours, and at 48 postoperative hours. Our findings suggested that, compared with the control group, the SVV group showed a faster postoperative SD time, reduced acute postoperative pain intensity, and lower rescue analgesics. Therefore, SVV-based optimal fluid management is expected to potentially contribute to postoperative bowel function recovery in patients undergoing colon resection surgery.

scholarly journals A Comparative Study of Intraoperative Fluid Management Using Stroke Volume Variation in Liver Resection

2018 ◽  
Vol 103 (3-4) ◽  
pp. 199-206
Author(s):  
K. Kitaguchi ◽  
N. Gotohda ◽  
H. Yamamoto ◽  
S. Takahashi ◽  
M. Konishi ◽  
...  
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Stroke Volume ◽  
Liver Surgery ◽  
Stroke Volume Variation ◽  
Fluid Management ◽  
Control Group ◽  
Fluid Restriction ◽  
Intraoperative Blood Loss ◽  
Liver Transection

Objective: The aim of this study is to examine whether intraoperative fluid management with stroke volume variation (SVV) can achieve safe intravenous fluid restriction and contribute to decreasing intraoperative blood loss in liver surgery. Background: In liver surgery, maintaining the central venous pressure (CVP) at a low level is effective in decreasing intraoperative blood loss. Recently, several studies have suggested that SVV obtained using the FloTrac system demonstrated a better fluid responsiveness than CVP. Methods: We enrolled 30 patients undergoing liver resection since May 2015 in this prospective observational study, and we set the SVV target during liver transection at 13%–20% (SVV group). Forty-three cases of liver resection that we performed between January 2014 and March 2015 without using CVP or SVV were used as the Control group. We compared the 2 groups by using intraoperative blood loss as the primary endpoint. Results: There was no significant difference in patient characteristics between the 2 groups. The mean SVV during liver transection in the SVV group was 15.6 ± 4.4%. The infusion volume until completion of liver transection in the Control group was 9.4 mL/kg/h, whereas that of the SVV group was 3.3 mL/kg/h, a significantly lower volume (P &lt; 0.001). The median intraoperative blood loss was significantly decreased in the SVV group compared with the Control group (391 versus 1068 mL; P &lt; 0.001). The intraoperative transfusion rate was also significantly decreased in the SVV group. Conclusion: We demonstrated that intraoperative management with SVV can achieve safe intravenous fluid restriction and is useful for decrease intraoperative blood loss in liver surgery.

scholarly journals Intraoperative fluid management in hepato-biliary-pancreatic operation using stroke volume variation monitoring

Medicine ◽  
2020 ◽  
Vol 99 (50) ◽  
pp. e23617
Author(s):  
Yudai Iwasaki ◽  
Yuko Ono ◽  
Ryota Inokuchi ◽  
Tokiya Ishida ◽  
Yoshibumi Kumada ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Fluid Management ◽  
Volume Variation

scholarly journals Echocardiographic measure of dynamic arterial elastance predict pressure response during norepinephrine weaning: an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maxime Nguyen ◽  
Osama Abou-Arab ◽  
Stéphane Bar ◽  
Hervé Dupont ◽  
Bélaïd Bouhemad ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Stroke Volume Variation ◽  
Pressure Variation ◽  
Pressure Response ◽  
Arterial Elastance ◽  
Volume Variation ◽  
Norepinephrine Dose ◽  
Stroke Volume Variations

AbstractThe purpose of this study was to determine whether dynamic elastance EAdyn derived from echocardiographic measurements of stroke volume variations can predict the success of a one-step decrease of norepinephrine dose. In this prospective single-center study, 39 patients with vasoplegic syndrome treated with norepinephrine and for whom the attending physician had decided to decrease norepinephrine dose and monitored by thermodilution were analyzed. EAdyn is the ratio of pulse pressure variation to stroke volume variation and was calculated from echocardiography stroke volume variations and from transpulmonary thermodilution. Pulse pressure variation was obtained from invasive arterial monitoring. Responders were defined by a decrease in mean arterial pressure (MAP) > 10% following norepinephrine decrease. The median decrease in norepinephrine was of 0.04 [0.03–0.05] µg kg−1 min−1. Twelve patients (31%) were classified as pressure responders with a median decrease in MAP of 13% [12–15%]. EAdyn was lower in pressure responders (0.40 [0.24–0.57] vs 0.95 [0.77–1.09], p < 0.01). EAdyn was able to discriminate between pressure responders and non-responders with an area under the curve of 0.86 (CI95% [0.71 to1.0], p < 0.05). The optimal cut-off was 0.8. EAdyn calculated from the echocardiographic estimation of the stroke volume variation and the invasive arterial pulse pressure variation can be used to discriminate pressure response to norepinephrine weaning. Agreement between EAdyn calculated from echocardiography and thermodilution was poor. Echocardiographic EAdyn might be used at bedside to optimize hemodynamic treatment.

scholarly journals Evaluation of Stroke Volume Variation Obtained by the FloTrac™/Vigileo™ System to Guide Preoperative Fluid Therapy in Patients Undergoing Brain Surgery

2012 ◽  
Vol 40 (3) ◽  
pp. 1175-1181 ◽  
Author(s):  
J Li ◽  
Fh Ji ◽  
Jp Yang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Brain Surgery ◽  
Fluid Loading ◽  
Volume Loading ◽  
Fluid Infusion ◽  
Volume Variation ◽  
Ringer’S Lactate

OBJECTIVE: The accuracy of stroke volume variation (SVV) obtained by the FloTrac™/Vigileo™ system in otherwise healthy patients undergoing brain surgery was assessed. METHODS: Anaesthesia was induced in 48 patients with minimal fluid infusion. Before surgery, fluid volume loading was performed by infusion with Ringer's lactate solution in 200 ml steps over 3 min, repeated successively if the patient responded with an increase in stroke volume of ≥ 10%, until the increase was < 10% (nonresponsive). RESULTS: A total of 157 volume loading steps were performed in the 48 patients. Responsive and nonresponsive steps differed significantly in baseline values of blood pressure, heart rate and SVV. Significant correlations were found between the change in stroke volume after fluid loading and values of blood pressure, heart rate and SVV before fluid loading, with SVV the most sensitive variable. CONCLUSION: Stroke volume variation obtained using the FloTrac™/Vigileo™ system is a sensitive predictor of fluid responsiveness in healthy patients before brain surgery.

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