TITLE:
Assessment of Pericardium Volume by the Stroke Volume Variation in Patients with Off-Pump Cardiac Surgery
AUTHORS:
Chenyang Dai, Guofeng Dai, Yuelan Wang, Mengjie Liu
KEYWORDS:
Stroke Volume Variations; Heart-Lung; Sternotomy; Monitoring; Functional Hemodynamic; Cardiac Surgery
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.3,
May
24,
2013
ABSTRACT: Objective: SVV is derived from the cardiopulmonary
interaction, which is used to predict the responsiveness of cardiac preload guiding
fluid therapy in patients under general anesthesia in non-opened chest surgery.
From a clinical point of view, it is important to know how well SVV reflects preload
and fluid responsiveness during cardiac surgery. This study was undertaken to assess
the accuracy and reliability of SVV derived from the FloTrac/Vigileo system in monitoring changes in blood volume in
patients undergoing off-pump coronary artery bypass grafting (OPCABG) under general
anesthesia. Methods: After approval from the ethics committee and obtaining
the permission of the patients, twenty-nine patients, ASA II-III and NYHA II-III,
aged 44-7 yr, undergoing elective off-pump coronary
artery bypass grafting, were
randomly divided into 2 groups: the control group (group C, n = 8) and volume expansion group (group V,
n = 21). After patients entered the operating
room, veins were put in line, ECG, HR, SpO2, and PETCO2 were continuously monitored. Left radial arterial
and right internal jugular vein catheters were inserted under local anesthesia. The FloTracTM/VigileoTM system was connected and MAP,
CO, CI, SVV, SV, SVI, SVR, SVRI, CVP were continuously monitored. BIS values were kept at
45%-55.6% hydroxyethyl starch 130/0.4 sodium chloride solution 7 ml/kg was intravenously infused after completion of sternotomy and pericardiotomy
at a rate of 0.25 ml/kg–1/min–1 in group V. MAP, HR, CVP, systemic
vascular resistance (SVR), SVV, and stroke volume index (SVI) were determined 10
min before (T1) and after the infusion of finished (T2), and
the change rate (ΔHR,
ΔMAP, ΔCVP, ΔSVR, ΔSVV, ΔSVI) was calculated. Sodium chloride injection 3 ml/kg
was infused in group C. Results: CVP, SVI, CO and CI were increased after volume expansion, SVRI and SVV significantly
decreased in group V(P r = –0.737, P and
SVR(r = –0.480, P were significantly correlated to changes
in SVI, but there was no correlation between ΔCVP, ΔMAP, ΔSVV and ΔSVI. SVV(