Effects of Goal-directed Volume Therapy on the Intracranial Pressure and the Balance of Cerebral Oxygen Consumption and Supply in Selective Neurosurgery
10.3870/j.issn.1672-0741.2015.01.021
- VernacularTitle:目标导向液体治疗在择期神经外科手术中对颅内压和脑氧供需平衡的影响
- Author:
Shenglan TIAN
;
You ZHOU
;
Dan FENG
- Publication Type:Journal Article
- Keywords:
goal-directed volume therapy;
intracranial pressure;
the balance of cerebral oxygen consumption and sup-ply;
selective neurosurgery
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2015;(1):106-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P<0.05).MAP ,CI ,and SjvO2 were much higher and CERO2 were much lower at T4 and T5 in group G than in group C(P<0.05). There was no significant differ‐ence in the ICP at each time point between groups G and C (P>0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.
