Goal Directed Fluid Therapy Guided Fluid Management in Pneumoresection
- Conditions
- Goal-directed Fluid Therapy
- Interventions
- Device: Fluid therapy
- Registration Number
- NCT03237351
- Lead Sponsor
- ZhiHeng Liu
- 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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- American Society of Anesthesiologists physical status I-III; aged 18-60 years old; BMI 18.5 ~ 28 kg/m2
- Refused to participate in the experiment, hepatic/renal/cardiac dysfunction, severe valvular disease, frequent arrhythmia, moderate anemia and severe electrolyte disturbance before operation.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Conventional therapy group Fluid therapy Patients in Conventional therapy group were received fluid therapy: intraoperative transfusion volume=maintenance fluids+deficit replacement+restoration of losses and with heart rate, mean arterial pressure, urine measurement ect. Low value of PPV group Fluid therapy Patients in low value of PPV group were received fluid therapy according to PPV (3% ≤PPV \< 5%) . High value of PPV group Fluid therapy Patients in high value of PPV group were received fluid therapy according to PPV (5% ≤PPV \< 8%) .
- Primary Outcome Measures
Name Time Method 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 Outcome Measures
Name Time Method The duration of surgery During surgery period The duration of mechanical ventilation During surgery period Urine output 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 Hospital stay postoperatively 1 month after surgery Crystalloid administered During surgery period Complication until hospital discharge 1 month after surgery Colloid administered During surgery period Blood loss During surgery period Number of patients received vasopressor During surgery period
Trial Locations
- Locations (1)
Shenzhen Second People's Hospital
🇨🇳Shenzhen, Guangdong, China