Efficacy of USCOM-monitored cardiac output and corrected flow time in guiding volume therapy in patients undergoing laparoscopic colorectal surgery
10.3760/cma.j.issn.0254-1416.2018.08.023
- VernacularTitle:USCOM监测CO和FTc指导腹腔镜直结肠癌根治术患者容量治疗的效果
- Author:
Zhongxin SHAO
1
;
Lu SUN
Author Information
1. 361000,厦门大学附属中山医院麻醉科
- Keywords:
Ultrasonography;
Fluid therapy;
Colonic neoplasms
- From:
Chinese Journal of Anesthesiology
2018;38(8):985-988
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of cardiac output ( CO ) and corrected flow time ( FTc) monitored by ultrasonic cardiac output monitor ( USCOM) in guiding volume therapy in patients un-dergoing laparoscopic colorectal surgery. Methods Eighty American Society of Anesthesiology physical sta-tus Ⅰ or Ⅱ patients, aged 18-60 yr, with body mass index of 18-25 kg∕m2 , undergoing laparoscopic colorectal surgery, were divided into 2 groups ( n=40 each) using a random number table method: control group ( group C ) and USCOM-guided fluid therapy group ( group U ) . Mean arterial pressure was main-tained at 60-100 mmHg, central venous pressure at 5-10 cmH2 O and urine volume>0. 5 ml·kg-1 ·h-1 u-sing conventional fluid therapy in group C. In group U, goal-directed fluid therapy was performed under the monitoring of USCOM, FTc was maintained at 326-400 ms and CO at 4. 2-5. 9 L∕min. The volume of crys-talloid and colloid solution, total volume of fluid infused, blood loss, urine volume and requirement for va-soactive agents during surgery and time of surgery were recorded. Blood samples were collected from the left radial artery for determination of the blood lactate concentration immediately after anesthesia induction, at the end of the operation and at 1 and 2 days after surgery. The time of passing the first flatus after surgery, adverse cardiovascular events ( hypertension, hypotension, cardiac insufficiency ) , pulmonary complica-tions ( pulmonary edema, pulmonary atelectasis) , and oliguria and anuria within 24 h after surgery, and length of hospital stay were recorded. Results Compared with group C, the volume of crystalloid, total volume of fluid infused and urine volume were significantly decreased during surgery, the volume of colloid solution was increased during surgery, the blood lactate concentration was decreased at the end of surgery, the incidence of postoperative cardiovascular and pulmonary complications was decreased, and the time of passing the first flatus after surgery and length of hospital stay were shortened in group U ( P<0. 05) . Con-clusion USCOM-monitored CO and FTc produces better efficacy in guiding volume therapy and is helpful for improving recovery in patients undergoing laparoscopic colorectal surgery.
