Int J Med Sci 2013; 10(4):355-361. doi:10.7150/ijms.5294
Effect of Rapid Plasma Volume Expansion during Anesthesia Induction on Haemodynamics and Oxygen Balance in Patients Undergoing Gastrointestinal Surgery
1. Department of Anaesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
2. Department of Anaesthesiology, No. 187 Hospital of PLA, Haikou, China.
Aims: To investigate the reasonable dose of Voluven for rapid plasma volume expansion during the anaesthesia induction patients receiving gastrointestinal surgery. Methods: Sixty patients were randomly divided into three groups (n=20): Group A (5 ml/kg), Group B (7 ml/kg) and Group C (9 ml/kg). HES 130/0.4 was intravenously transfused at a rate of 0.3 ml/kg/min) at 30 min before anaesthesia induction. Besides standard haemodynamic monitoring, cardiac index (CI), systemic vascular resistance index (SVRI) and stroke volume variation (SVV) was continuously detected with the FloTrac/Vigileo system. Haemodynamic variables were recorded immediately before fluid transfusion (T0), immediately before induction (T1), immediately before intubation (T2), immediately after intubation (T3) and 5 min, 10 min, 20 min and 60 min after intubation (T4-T7). Arterial and venous blood was collected for blood gas analysis, Hb and Hct before volume expansion (t0), immediately after volume expansion (t1) and at 1 h after volume expansion (t2). Oxygen delivery (DO2), oxygen extraction ratio (ERO2) and volume expansion rate were calculated. Results: 1) MAP and CI decreased in Group A in T2~T7 and remained changed in Group B and C. 2) CVP increased in three groups after fluid infusion without significant difference. 3) The decrease in SVRI was more obvious in Group B and C than that in Group A after induction and more obvious in Group C than in Group B in T2-T4 and T6~T7. 4) SVV was lower in Group B and C than that in Group A after intubation, and lower in Group C than that in Group B in T3-T6. 5) Hb and Hct decreased after fluid infusion, and the decrease in Hb and Hct was in the order of C>B>A. 6) Volume expansion rate was in the order of C>B>A. 7) ScvO2, PaO2 and DO2 increased in three groups after fluid infusion and the increase in DO2 was in the order of C>B>A. Conclusions: Rapid plasma volume expansion with Voluven at 7-9 ml/kg can prevent haemodynamic fluctuation during anaesthesia induction, maintain the balance between oxygen supply and oxygen consumption during gastrointestinal surgery, and Voluven at 9 ml/kg can improve the oxygen delivery.
Keywords: Hydroxyethyl starch, General anaethesia, Haemodynamics, Oxygen balance, Gastrointestinal surgery.
Lin Fq, Li C, Zhang Lj, Fu Sk, Chen Gq, Yang Xh, Zhu Cy, Li Q. Effect of Rapid Plasma Volume Expansion during Anesthesia Induction on Haemodynamics and Oxygen Balance in Patients Undergoing Gastrointestinal Surgery. Int J Med Sci 2013; 10(4):355-361. doi:10.7150/ijms.5294. Available from http://www.medsci.org/v10p0355.htm