| Influence of systolic-pressure-variation-guided intraoperative fluid management on organ function and oxygen transport. | |
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MedLine Citation:
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PMID: 18511439 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Dynamic variables, for example, systolic pressure variation (SPV), are superior to filling pressures for assessing fluid responsiveness. We analysed the effects of SPV-guided intraoperative fluid management on organ function and perfusion when compared with routine care. METHODS: Eighty patients (44 female and 36 male) undergoing elective major abdominal surgery were randomly assigned to a control group [n=40, mean age 66 (sd 10), range 40-84 yr] or SPV group [n=40, age 61 (16), range 26-100 yr] in which intraoperative fluid management was guided by SPV (trigger: SPV>10%). Central venous O2 saturation (ScvO2), lactate and bilirubin, creatinine, indocyanine green plasma disappearance rate (ICG-PDR), and gastric mucosal CO(2) tension were measured after induction of anaesthesia, after 3, 6, 12, and 24 h. RESULTS: Patient characteristics, duration of surgery [5.8 (2.5) vs 5.4 (2.5) h], and infusion volumes (median 4865 vs 4330 ml) were comparable between the groups. At 3 and 6 h, SPV (P=0.04, P=0.01) and Deltadown (P=0.005, P=0.01) were significantly higher in the control group. Oxygen transport and organ function were comparable: baseline and 24 h values for ICG-PDR: 28.5 (7.9) and 22.7 (7.8) vs 23.9 (6.9) and 26.1 (5.9)% min(-1), 77.7 (6.6) and 72.6 (5.5) vs 79.3 (7.1) and 72.8 (6.7)% for ScvO2 and 1.0 (0.4) and 1.2 (0.6) vs 0.9 (0.2) and 1.3 (0.5) mmol litre(-1) for lactate. Length of mechanical ventilation, ICU stay, and mortality were comparable. CONCLUSIONS: In comparison with routine care, intraoperative SPV-guided treatment was associated with slightly increased fluid adminstration whereas organ perfusion and function was similar. |
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Authors:
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M Buettner; W Schummer; E Huettemann; S Schenke; N van Hout; S G Sakka |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2008-05-28 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 101 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-10 Completed Date: 2008-08-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 194-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Intensive Care Medicine, Hospital Worms, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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surgery Adult Aged Aged, 80 and over Blood Pressure* Female Fluid Therapy / methods* Hemodynamics Humans Intraoperative Care / methods* Male Middle Aged Monitoring, Intraoperative / methods Oxygen / blood |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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