Application of stroke volume variation in acute non-normovolemic hemodilution
LIU Xiaomei1, DONG Lan2, JIN Bing3
1.Department of Anesthesiology, 3.Department of Blood Transfusion,the Sixth Medical Center of PLA General Hospital,Beijing 100048, China; 2. Department of Anesthesiology, the Third Medical Center of PLA General Hospital,Beijing 100039, China
Abstract：Objective To investigate the applicability of stroke volume variation(SVV) in acute non-normovolemic hemodilution. Methods Sixty patients were enrolled in this study who were scheduled to receive elective surgery at our hospital between March 2017 and December 2017 under general anesthesia. They were randomly divided into the control group (group C) and the observation group (group O), with 30 cases in each group. MAP, HR, SVV, hemoglobin(Hb) and hematocrit (Hct) of the two groups were recorded before blood collection (T0), upon the collection of 100 ml of blood (T1), 200 ml of blood (T2), 300 ml of blood (T3) and at the end of blood collection(T4) respectively, so were the duration of blood collection, total colloid collection and the urine volume. Results The levels of SVV[(9.8±1.2)%] at T4 were higher than at T0[(5.5±1.3)%] (P＜0.05) in group O, but there was no significant difference between T0,T1 and T3. The levels of MAP at T2-T4 were lower than at T0 while the levels of HR at T2-T4 were higher than at T0 (P＜0.05) in group C, but there was no significant difference between T0 and T1. The levels of Hb and HCT in group O were significantly lower than those in group C, while the total volume of blood collection and colloid collection in group O were significantly higher than those in group C(P＜0.05). Conclusions SVV monitoring can better maintain hemodynamic stability than MAP and HR, which is more conductive to acute non-normovolemic hemodilution during surgery.
Kumar A, Anel R, Bunnell E, et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects[J]. Crit Care Med, 2004,32(3):691-699.
[5]
Kelm D J,Perrin J T,Cartin C R,et al.Fulid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death[J].Shock,2015,43(1):68-73.
[6]
Khosroshahi H E,Ozkan E A,Kilic M.Arterial and left ventricular end-systolic elastance in normal children[J].Eur Rev Med Pharmacol Sci,2014,18:3260-3266.
[7]
Vincent J,Pelosi P,Pearse R,et al.Perioperative cardiovascular monitoring of high-risk patients:a consensus of 12[J].Crit Care,2015,19(5):224-236.
[8]
Martin P,Herbert S,Claudia K,et al.Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs[J].BMC Anesthesiology,2015,133(15):1-10.
[9]
Chin J H,Jun I G,Lee J,et al.Can stroke volume variation be an alternative to central venous pressure in patients undergoing kidney transplantation?[J].Transplant Proc,2014,46(10):3363-3366.
Derichard A,Robin E,Tavernier B, et al. Automated pulse pressure and stroke volume variations from radial artery: Evaluation during major abdominal surgery[J].Br J Anaesth,2009,103(5):678-684.
[14]
Miller T E,Roche A M,Gan T J.Poor adoption of hemodynamic optinmization during major surgery:Are we practicing substandard care[J].Anesth Analg,2011,112(6):1274-1276.
[15]
Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness? a syetematic review of the literature and the tale of seven mares [J].Chest,2008,134(1):172-178.
Biais M, Bernard O, Ha J C, et al .Abilities of pulse pressure variations and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery[J].Br J Anaesth,2010,104(4):407-413.
[18]
Analo,Helena V,Carlos V,et al.The inuence of Ringer,slactate or HES130/0.4 adm in istration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia[J]. J Vet Emerg Crit Care, 2016,10(4):1-12.
[19]
Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness? A syetematic review of the literature and the tale of seven mares [J].Chest,2016,134(1):172-178.
[20]
Rasmussen K C,Johnsson P,Hojskov M,et al.Hydroxyethyl starch reduces coagulation competence and increase blood loss during major surgery:results from a randomized controlled trial[J].Annals Surgery,2014,259(2):249-254.
[21]
Challand C,Struthers R,Sneyd J R,et al.Randomized controlled trail of intraoperative goal-directed fluid therapy in aerobically fit and unfit patient having major colorectal sugery[J].Br J Anaesth,2012,108(1):53-62.
2019, Vol. 30 
