Effectiveness of central venous pressure versus stroke volume variation in guiding fluid management in renal transplantation.

OBJECTIVE

The aim of this study was to compare the effectiveness of central venous pressure (CVP) versus stroke volume variation (SVV) to guide fluid management in renal transplantation.

METHODS

The clinical data of 97 patients who underwent allogeneic renal transplantation in our hospital were collected retrospectively. Based on the method of intraoperative infusion monitoring, they were divided into group A, which received guided fluid management by monitoring CVP, and group B which received guided fluid management by monitoring SVV. The changes in intraoperative hemodynamic indicators, urine volume, blood loss, and total blood transfusion volume, total fluid volume, urine output at different time points after surgery, renal function indicators, blood purification rate, length of stay, and postoperative complications were compared between the two groups.

RESULTS

CVP values at T1 (5 min before surgery), T2 (external iliac vein obstruction), T3 (establishment of vessel access), and T4 (end of surgery) in group B were higher than those in group A (<0.05). The two groups showed no significant difference in intraoperative urine volume, blood loss and length of hospital stay (>0.05). The total fluid volume and total infusion volume at 3 days after surgery in group B were less than those in group A (<0.05). The urine volume did not differ at time points 0 h, 24 h, 48 h and 72 h postoperatively (>0.05). Serum creatinine levels in group B at 0 h, 24 h, 48 h and 72 h postoperatively were lower than those in group A (<0.05). After renal transplantation, the rate of blood purification was 4.08% in group B, which was lower than 25.00% in group A (<0.05). The rate of respiratory failure in group B was 4.08%, which was not significantly different from 6.25% in group A (>0.05).

CONCLUSION

Compared with CVP, fluid management guided by monitoring SVV during renal transplantation can reduce intraoperative fluid volume, optimize the renal perfusion, reduce postoperative blood purification, and facilitate postoperative recovery.