Effects of stroke volume variation or central venous pressure guided fluid management on patients undergoing gastrointestinal surgery

Objective To investigate the clinical efficacy and safety of stroke volume variation guided fluid management for patients undergoing gastrointestinal surgery.Methods Forty ASA class Ⅰ-Ⅲ,consecutive consenting patients undergoing gastrointestinal surgery were randomized to stroke volume variation guided (group SVV) and central venous pressure (CVP)-based (conventional) intraoperative fluid management (group CVP). The group SVV patients followed a dynamic stroke volume variation guided fluid protocol maintaining SVV at 10%-12% whereas group CVP patients were managed using routine cardiovascular monitoring aiming for a CVP between 8 and 10 mm Hg.HR,SpO2,RR,ECG,PETCO2 and IBP were monitored during operation.The liquid and blood input, blood loss,time of full or semi-liquid diet,time of defecation and exhaust,rate of complications at 48 h of postoperation such as pulmonary infection and length of stay were recored.Results The volume of fluid and crystalloid/colloid solution received during operation in group SVV was significantly lower than those in group CVP (P0.05). The median time to resuming semi-liquid diet and the median postoperative stay in group SVV was obviously shorter than those in group CVP (P0.05). There is no difference between the two groups on the full liquid diet time, exhaust time, defecation time, incidence of complications such as nausea and vomiting during postoperation period.Conclusion Compared with CVP-based intraoperative fluid management, intraoperative stroke volume variation guided fluid management decreases the fluid volume during operation and the hospital stay.