title: Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study.
abstract: OBJECTIVE
  This pilot study was designed to utilize stroke volume variation and cardiac index to ensure fluid optimization during one-lung ventilation in patients undergoing thoracoscopic lobectomies.
  
  
  METHODS
  Eighty patients undergoing thoracoscopic lobectomy were randomized into either a goal-directed therapy group or a control group. In the goal-directed therapy group, the stroke volume variation was controlled at 10%±1%, and the cardiac index was controlled at a minimum of 2.5 L.min-1.m-2. In the control group, the MAP was maintained at between 65 mm Hg and 90 mm Hg, heart rate was maintained at between 60 BPM and 100 BPM, and urinary output was greater than 0.5 mL/kg-1/h-1. The hemodynamic variables, arterial blood gas analyses, total administered fluid volume and side effects were recorded.
  
  
  RESULTS
  The PaO2/FiO2-ratio before the end of one-lung ventilation in the goal-directed therapy group was significantly higher than that of the control group, but there were no differences between the goal-directed therapy group and the control group for the PaO2/FiO2-ratio or other arterial blood gas analysis indices prior to anesthesia. The extubation time was significantly earlier in the goal-directed therapy group, but there was no difference in the length of hospital stay. Patients in the control group had greater urine volumes, and they were given greater colloid and overall fluid volumes. Nausea and vomiting were significantly reduced in the goal-directed therapy group.
  
  
  CONCLUSIONS
  The results of this study demonstrated that an optimization protocol, based on stroke volume variation and cardiac index obtained with a FloTrac/Vigileo device, increased the PaO2/FiO2-ratio and reduced the overall fluid volume, intubation time and postoperative complications (nausea and vomiting) in thoracic surgery patients requiring one-lung ventilation.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital College of Medicine, Zhejiang University, Hangzhou, Zhejiang/China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Chao Qin
authors.initials: CQ
authors.lastname: Chen
authors.forename: Xiu Zhen
authors.initials: XZ
authors.lastname: Lei
authors.forename: Zhi Ying
authors.initials: ZY
authors.lastname: Feng
authors.forename: Sheng Mei
authors.initials: SM
authors.lastname: Zhu
mesh_terms: D000368:Aged; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D062186:Arterial Pressure / Q000502:physiology; D001784:Blood Gas Analysis; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D061810:One-Lung Ventilation / Q000379:methods*; D010865:Pilot Projects; D011013:Pneumonectomy / Q000379:methods*; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology*; D013906:Thoracoscopy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
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