The Application of Goal-directed Therapy With the Combination of Stroke Volume Variation and Cardiac Index as the Primary Judgment in Non-severe Patients Underwent Gastrointestinal Tumor Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Fluid Therapy
- Sponsor
- First Affiliated Hospital, Sun Yat-Sen University
- Enrollment
- 50
- Primary Endpoint
- Number of Days Needed for Anal Exsufflation After Surgery
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
To evaluate the application of fluid-infusion therapy with the combination of stroke volume variation (SVV) and cardiac index (CI) as the primary judgment in non-severe patients underwent resection of gastrointestinal tumor. Fifty patients (ASA Ⅰ-Ⅱ, 26-55 years old, cardiac functional gradingⅠ) scheduled for gastrointestinal tumor surgery were divided into two groups randomly: group C with CI as the primary judgment and group S with the combination of SVV and CI as the primary judgment.
Detailed Description
To evaluate the application of fluid-infusion therapy with the combination of stroke volume variation (SVV) and cardiac index (CI) as the primary judgment in non-severe patients underwent resection of gastrointestinal tumor. Methods: Fifty patients (ASA Ⅰ-Ⅱ, 18-55 years old, cardiac functional gradingⅠ) scheduled for gastrointestinal tumor surgery were divided into two groups randomly: group C with CI as the primary judgment and group S with the combination of SVV and CI as the primary judgment. Patients in group C received a therapy with the goal of CI was no less than 2.5L•min-1•m-2 while SVV was less than 12% and CI was no less than 2.5L•min-1•m-2 in group S. Indexes including MAP、HR、CVP、CI、SVV were recorded at the moment after anaesthetized (T1), when skin was incised (T2), when the intestina was anastomosed (T3) and after the abdomen was closed (T4). SaO2、ScvO2 and plasma lactic were determined at T1 and T4 and DO2,VO2 and ERO2 during the surgery were calculated .The volume of fluid, vasoactive drugs use, the incidence of adverse cardiovascular events, the convalescence of intestinal peristalsis, hospital stay and postoperative complications were recorded.
Investigators
Lin Yang
Attending Physician
First Affiliated Hospital, Sun Yat-Sen University
Eligibility Criteria
Inclusion Criteria
- •American Society of Anesthesiologists (ASA) physical status of grade I-II
- •Cardiac function classification by NYHA of grade I
- •without high risk factors according to the revised Lee cardiac risk index:
- •High-risk type of surgery
- •Ischemic heart disease
- •History of congestive heart failure
- •History of cerebrovascular disease
- •Insulin therapy for diabetes
- •Preoperative serum creatinine \> 2.0 mg/dl
- •undergoing gastrointestinal tumor surgery
Exclusion Criteria
- •Patients under 18 years or above 55 years
- •patients with severe aortic regurgitation
- •patients with permanent cardiac arrhythmias
- •patients with intra-aortic balloon pump
- •patients with severe pulmonary disease
- •patients with hepatic or renal dysfunction
- •patients undergoing emergency surgery
Outcomes
Primary Outcomes
Number of Days Needed for Anal Exsufflation After Surgery
Time Frame: up to 8 weeks
record the number of days needed for anal exsufflation in non-severe patients after gastrointestinal tumor surgery
Secondary Outcomes
- Oxygen Consumption（VO2）(during the surgery)
- Oxygen Extraction Rate（ERO2）(during the surgery)
- Number of Days in Hospital(up to 10 weeks)
- the Incidence of Adverse Cardiovascular Events(during the surgery)
- Oxygen Delivery（DO2）(during the surgery)