Yilmaz Gulseren, Akca Aysu, Kiyak Huseyin, Can Esra, Aydin Alev, Salihoglu Ziya
Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Faculty of Medicine, Kanuni Sultan Suleyman Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Faculty of Medicine, Kanuni Sultan Suleyman Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2022 Jun 28;56(2):220-226. doi: 10.14744/SEMB.2021.81073. eCollection 2022.
Data concerning the usefulness of pleth variability index (PVI)-based goal-directed fluid management (GDFM) in gynecologic surgery is limited.This study purposed to compare the impact of PVI-based GDFM to conventional fluid management (CFM) on intraoperative hemodynamics and lactate levels in subjects undergoing gynecologic surgery.
This randomized and controlled trial was conducted on 70 patients undergoing elective gynecologic surgery. Subjects were randomly assigned to CFM or GDFM. Hemodynamic data and results of the arterial blood gas analysis, and total amount of the fluid infused were recorded throughout the surgery at 1-h intervals.
The amount of the total fluids was significantly higher in the CFM group compared to that of the GDFM group (p<0.001). Mean arterial pressure recorded at the 2 h of the surgery was significantly lower in the CFM group compared to that of the GDFM group (p=0.047). While there were no significant differences between the baseline and the 2 h lactate levels in the GDFM group, the lactate level significantly increased from baseline to the 2 h in the CFM group (p=0.010).
Implementation of PVI-based GDFM provides better intraoperative hemodynamic stability and lower lactate levels compared to the CFM in subjects undergoing gynecologic surgery.
关于基于脉压变异指数（PVI）的目标导向液体管理（GDFM）在妇科手术中的效用的数据有限。本研究旨在比较基于PVI的GDFM与传统液体管理（CFM）对接受妇科手术患者术中血流动力学和乳酸水平的影响。
本随机对照试验对70例接受择期妇科手术的患者进行。受试者被随机分配至CFM组或GDFM组。在整个手术过程中，每隔1小时记录血流动力学数据、动脉血气分析结果以及输注的液体总量。
CFM组的总液体量显著高于GDFM组（p<0.001）。手术2小时时记录的平均动脉压，CFM组显著低于GDFM组（p=0.047）。GDFM组基线和2小时时的乳酸水平无显著差异，而CFM组的乳酸水平从基线到2小时显著升高（p=0.010）。
与CFM相比，在接受妇科手术的患者中实施基于PVI的GDFM可提供更好的术中血流动力学稳定性和更低的乳酸水平。
