title: Intraoperative volume restriction in esophageal cancer surgery: an exploratory randomized clinical trial.
abstract: OBJECTIVE
  To investigate whether the fluid volume administered during esophageal cancer surgery affects pulmonary gas exchange and tissue perfusion.
  
  
  METHODS
  An exploratory single-center randomized clinical trial was performed. Patients with esophageal cancer who underwent Lewis-Tanner procedure between June 2011 and August 2012 at the Department of Thoracic surgery "Jordanovac", Zagreb were analyzed. Patients were randomized (1:1) to receive a restrictive volume of intraoperative fluid (≤8 mL/kg/h) or a liberal volume (>8 mL/kg/h). Changes in oxygen partial pressure (Pao2), inspired oxygen fraction (FiO2), creatinine, and lactate were measured during and after surgery.
  
  
  RESULTS
  Overall 16 patients were randomized and they all were analyzed (restrictive group n=8, liberal group n=8). The baseline value Pao2/FiO2 ratio (restrictive) was 345.01±35.31 and the value six hours after extubation was 315.51±32.91; the baseline Pao2/FiO2 ratio (liberal) was 330.11±34.71 and the value six hours after extubation was 307.11±30.31. The baseline creatinine value (restrictive) was 91.91±12.67 and the value six hours after extubation was 100.88±18.33; the baseline creatinine value (liberal) was 90.88±14.99 and the value six hours after extubation was 93.51±16.37. The baseline lactate value (restrictive) was 3.93±1.33 and the value six hours after extubation was 2.69±0.91. The baseline lactate value (liberal) was 3.26±1.25 and the value six hours after extubation was 2.40±1.08. The two groups showed no significant differences in Pao2/FiO2 ratio (P=0.410), creatinine (P=0.410), or lactate (P=0.574).
  
  
  CONCLUSIONS
  Restriction of intraoperative applied volume does not significantly affect pulmonary exchange function or tissue perfusion in patients undergoing surgical treatment for esophageal cancer.
authors.affiliation: Maja Karaman Ilić, University Hospital Centre Zagreb, Department of Anesthesiology, Jordanovac 104, 10000 Zagreb, Croatia, majakilic1@gmail.com.
authors.forename: Maja
authors.initials: M
authors.lastname: Karaman Ilić
authors.forename: Goran
authors.initials: G
authors.lastname: Madžarac
authors.forename: Jana
authors.initials: J
authors.lastname: Kogler
authors.forename: Dinko
authors.initials: D
authors.lastname: Stančić-Rokotov
authors.forename: Nevenka
authors.initials: N
authors.lastname: Hodoba
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011659:Pulmonary Gas Exchange