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Changes in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial.
Minerva Anestesiol. 2020 May; 86(5):507-517.MA

Abstract

BACKGROUND

The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy.

METHODS

Patients were randomly allocated into one of two groups according to the SVV criteria for fluid administration during surgery. In the fixed SVV fluid strategy group, fluid was administered to maintain the SVV below 13%. In the individual SVV group, individual SVV values of each patient were maintained until the end of surgery. Plasma volume, body weight, and extracellular water (ECW) were measured before and after surgery. Plasma volume was estimated using the indocyanine green dilution technique.

RESULTS

A total of 118 patients were included. Median (25-75%) plasma volumes in the preoperative and postoperative period were 2.46 (2.20-2.88) L and 2.69 (2.33-3.12) L for the fixed SVV group (N.=57, P=0.133), respectively, and 2.56 (2.23-2.90) L and 2.89 (2.48-3.19) L for the individual SVV group (N.=61, P<0.001), respectively.

CONCLUSIONS

Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.University of Ulsan College of Medicine, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.Department of Statistics, Ewha Womans University, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea - nohgj@amc.seoul.kr. Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31808664

Citation

Lee, Yong-Hun, et al. "Changes in Plasma Volume Before and After Major Abdominal Surgery Following Stroke Volume Variation-guided Fluid Therapy: a Randomized Controlled Trial." Minerva Anestesiologica, vol. 86, no. 5, 2020, pp. 507-517.
Lee YH, Jang HW, Park CH, et al. Changes in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial. Minerva Anestesiol. 2020;86(5):507-517.
Lee, Y. H., Jang, H. W., Park, C. H., An, S. M., Lee, E. K., Choi, B. M., & Noh, G. J. (2020). Changes in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial. Minerva Anestesiologica, 86(5), 507-517. https://doi.org/10.23736/S0375-9393.19.13952-1
Lee YH, et al. Changes in Plasma Volume Before and After Major Abdominal Surgery Following Stroke Volume Variation-guided Fluid Therapy: a Randomized Controlled Trial. Minerva Anestesiol. 2020;86(5):507-517. PubMed PMID: 31808664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial. AU - Lee,Yong-Hun, AU - Jang,Hye-Won, AU - Park,Chan-Hye, AU - An,Sang-Mee, AU - Lee,Eun-Kyoung, AU - Choi,Byung-Moon, AU - Noh,Gyu-Jeong, Y1 - 2019/12/04/ PY - 2019/12/7/pubmed PY - 2019/12/7/medline PY - 2019/12/7/entrez SP - 507 EP - 517 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 86 IS - 5 N2 - BACKGROUND: The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy. METHODS: Patients were randomly allocated into one of two groups according to the SVV criteria for fluid administration during surgery. In the fixed SVV fluid strategy group, fluid was administered to maintain the SVV below 13%. In the individual SVV group, individual SVV values of each patient were maintained until the end of surgery. Plasma volume, body weight, and extracellular water (ECW) were measured before and after surgery. Plasma volume was estimated using the indocyanine green dilution technique. RESULTS: A total of 118 patients were included. Median (25-75%) plasma volumes in the preoperative and postoperative period were 2.46 (2.20-2.88) L and 2.69 (2.33-3.12) L for the fixed SVV group (N.=57, P=0.133), respectively, and 2.56 (2.23-2.90) L and 2.89 (2.48-3.19) L for the individual SVV group (N.=61, P<0.001), respectively. CONCLUSIONS: Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/31808664/Changes_in_plasma_volume_before_and_after_major_abdominal_surgery_following_stroke_volume_variation-guided_fluid_therapy:_a_randomized_controlled_trial L2 - https://www.minervamedica.it/index2.t?show=R02Y2020N05A0507 DB - PRIME DP - Unbound Medicine ER -
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