How can fluid therapy be better regulated in lung operations?

Not Applicable

Completed

• Conditions: Fluid management during lobectomy; Anaesthesiology - Other anaesthesiology

• Registration Number: ACTRN12618000537257
• Lead Sponsor: Cengiz Sahutoglu

Brief Summary

Results One hundred and ninety-eight patients were enrolled in the study and 88 patients completed it. The mean age of the study population was 56.9±14.4 years (range 20–78 years), and 75% of the patients (66 patients) were male. Of these patients, 89.8% and 10.2% underwent lobectomy due to a lung tumor and bronchiectasis, respectively. Of these patients, 25% had more than one systemic disease, while 39.8% did not have any comorbid conditions. Twenty-two patients had hypertension (12 in group 1 vs 10 in group 2), 12 patients had coronary artery disease (3 in group 1 vs 9 in group 2), 10 patients had diabetes mellitus (4 in group 1 vs 6 in group 2), 18 patients had chronic obstructive pulmonary disease (6 in group 1 vs 12 in group 2), three patients had cerebrovascular disease (1 in group 1 vs 2 in group 2), 10 patients had multinodular goitre (5 in group 1 vs 5 in group 2), and 64 patients were smokers. End of surgery CVP was higher in group 2 (CVP group) than group 1 (SVV group). All patients’ end of surgery CVP levels were higher than their baseline CVP levels (9.22±3.6 mmHg vs 8±2.6 mmHg). In addition, SVV was used in fluid therapy for 48.9% of the patients. In the SVV group, 62.8% of patients (27 patients) responded to fluid therapy (fluid responsiveness was defined as an increase in SVI = 10% after fluid challenge). The mean SVV value in the SVV group was 10.5%±3.5% (4–18) at baseline and 12.2%±5.3% (2–22) after surgery. Only 25.6% of the patients had baseline SVV = 13%. The decrease in SVV during the OLV period was not significant when compared with baseline values. However, the mean SVV values during closed thoracic surgical periods were higher than values during OLV periods. The use of SVV resulted in increased use of crystalloids and colloids with increased urine output per hour. On the other hand, no significant difference in the length of hospital stay and the rate of complications was observed between the groups. Furthermore, at least one complication occurred in 41.8% of the SVV group and 51.1% of the CVP group. The rate of respiratory complications including atelectasis, pneumonia, hypoxemia, air leak< 5 days, and increased production of secretions was 21% (n=9) in the SVV group and 37.7% (n=17) in the CVP group. Of the patients, 13.6% had an increased production of secretions, 15.9% developed atelectasis, 8% developed pneumonia,9.1% developed air leak .5 days, and 5.7% developed hypoxemia. No patient needed either tracheal intubation or mechanical ventilation. Of all patients, 5.7% developed cardiac complications and 3.4% developed acute renal failure (did not require dialysis).

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2016-04-29
• Study Start: 2018-04-11
• Last Update Posted: 15 July 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 88

Inclusion Criteria

Patients undergoing lobectomy

Exclusion Criteria

Patients undergoing surgical procedures other than lobectomy
those with severe valvular disease and arrhythmia
respiratory function test results below 50%
severe organ failure (kidney, liver, and heart failure)
patients without epidural catheter
pediatric cases

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The primary endpoint was included the amounts of intraoperative fluid administration between the SVV group and CVP group during one-lung ventilation and lobectomy. The amount of intraoperative fluid administration was recorded in patients charts.[intraoperative period.]