Assessment of Pericardium Volume by the Stroke Volume Variation in Patients with Off-Pump Cardiac Surgery

Chenyang Dai, Guofeng Dai, Yuelan Wang, Mengjie Liu

Department of Anesthesiology, Qianfo Mountain Hospital of Shandong University, Jinan, China..
Department of Clinical Medicine, Shandong University, Jinan, China.
Department of Orthopedics, Qilu Hospital of Shandong Uni- versity, Jinan, China.

DOI: 10.4236/ojanes.2013.33047                

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 P_ETCO₂ were continuously monitored. Left radial arterial and right internal jugular vein catheters were inserted under local anesthesia. The FloTrac^TM/Vigileo^TM 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 < 0.01), while MAP and HR were not changed. Changes in HR(r = –0.737, P < 0.05) and SVR(r = –0.480, P < 0.05) were significantly correlated to changes in SVI, but there was no correlation between ΔCVP, ΔMAP, ΔSVV and ΔSVI. SVV(

Keywords

Stroke Volume Variations; Heart-Lung; Sternotomy; Monitoring; Functional Hemodynamic; Cardiac Surgery

Conflicts of Interest

The authors declare no conflicts of interest.

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