|Table of Contents|

Application of intraoperative goal-directed fluid therapy in children undergoing resection of huge retroperitoneal tumor

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2021 02
Page:
323-326
Research Field:
Publishing date:

Info

Title:
Application of intraoperative goal-directed fluid therapy in children undergoing resection of huge retroperitoneal tumor
Author(s):
LIU Guang1; 2; LIU Zhina1; 2; ZHANG Ling1; 2; WANG Huise1; 2; LIN Yi1; 2; ZHANG Yatao1; 2; TAO Jin2; 3; LIU Chuang2; 3
1.Department of Anesthesiology；3Pediatric Surgery，Baoding Branch of Beijing Children's Hospital，Baoding Children's Hospital,Hebei Baoding 071000,China；2.Baoding Children's Respiratory and Digestive Diseases Clinical Research Key Laboratory,Hebei Baoding 071000,China.
Keywords:
goal-directed fluid therapy; pulse pressure variation; child; malignant tumor
PACS:
R730.5
DOI:
10.3969/j.issn.1672-4992.2021.02.030
Abstract:
Objective:To explore the application of goal-directed fluid therapy (GDFT) guided by pulse pressure variation (PPV) in the resection of huge retroperitoneal tumor.Methods:64 cases underwent the resection of huge retroperitoneal tumor (aged 0.5~3 years old,ASA grade Ⅱ-Ⅲ) were randomly divided into two groups using a random number table,including GDFT group (group G,n=32) and control group (group C,n=32).Group G was treated with GDFT guided by PPV and group C with conventional liquid therapy.The values of MAP,CVP,PPV,Lac,TNF-α and IL-6 were recorded at the beginning of operation (T1),1 hour after the beginning of operation (T2),and at the end of operation (T3).The requirement for crystalloid fluid and colloid,total volume of fluid infused,bleeding volume,urine volume,operation time,dopamine use rate,exhaust time,postoperative hospital stay time and incidence of nausea and vomiting were recorded.Results:The volume of crystalloid fluid in group G was significantly lower than that in group C(P＜0.05),while the volume of colloid fluid in group G was significantly more than that in group C(P＜0.05).There was no significant difference between the two groups in the total volume of fluid infused,blood loss,urine volume and dopamine use rate.At T2 and T3,PPV,TNF-α and IL-6 in group G were significantly lower than those in group C(P＜0.05),while MAP,CVP and Lac in the two groups had no significant difference at each time point.The postoperative exhaust time in group G was significantly shorter than that in group C.There was no significant difference in the incidence of postoperative nausea and vomiting and the hospital stay time between the two groups.Conclusion:GDFT guided by PPV can be used in children with huge retroperitoneal tumor resection,which can maintain the hemodynamic stability,reduce the release of IL-6,TNF-α,and promote the recovery of gastrointestinal function,but has no significant impact on the postoperative outcome.

References:

［1］TSENG WW,WANG SC,EICHLER CM,et al.Complete and safe resection of challenging retroperitoneal tumors:anticipation of multiorgan and major vascular resection and use of adjunct procedures［J］.World J Surg Oncol,2011,9(1):143.
[2]高志峰,冯艺,谷洁,等.目标导向液体治疗在腹部肿瘤切除术中的应用［J］.中国医药,2017,12(10):1560-1564. GAO ZF,FENG Y,GU J,et al.Application of goal-directed fluid therapy in patients undergoing retroperitoneal tumor resection［J］.China Medicine,2017,12(10):1560-1564.
[3]王晶晶,孙西龙,陈秀霞.目标导向液体治疗在幕上肿瘤切除术中的应用研究［J］.国际麻醉学与复苏杂志,2019,40(4):302-306. WANG JJ,SUN XL,CHEN XX.Application of the goal-directed fluid therapy in supratentorial tumor resection［J］.Int J Anesth Resus,2019,40(4):302-306.
[4]MYLES PS，BELLOMO R，CORCORAN T，et al.Restrictive versus liberal fluid therapy for major abdominal surgery［J］.N Engl J Med,2018,378(24):2263-2274.
[5]NAVARRO LH,BLOOMSTONE JA,AULER JO JR,et al.Perioperative-uid therapy:A statement from the international Fluid Optimization Group［J］.Perioper Med (Lond),2015,4(1):1-20.
[6]ANDERS WV,BIRGITTE B.Fluid therapy in the perioperative setting-a clinical review［J］.J Inten Care,2016,4(27):1-12.
[7]ALLEN SJ.Fluid therapy and outcome:Balance is best［J］.J Extra Corpor Technol,2014,46(1):28-32.
[8]CHOI SS,JUN IG,CHO SS,et al.Effect of stroke volume variation-directed fluid management on blood loss during living-donor right hepatectomy:A randomised controlled study［J］.Anaesthesia,2015,70(11):1250-1258.
[9]刘亚光,韩丁,欧阳川.脉压变异度和每搏量变异度在室间隔缺损患儿术中预测容量反应的探讨［J］.中国体外循环杂志,2018,16(6):334-338. LIU YG,HAN D,OUYANG C.Prediction of fluid responsiveness by pulse pressure variation and stroke volume variation in children with ventricular septal defect during cardiac surgery［J］.Chin J ECC,2018,16(6):334-338.
[10]BIAIS M,NOUETTE-GAULAIN K,COTTENEEAU V,et al.Cardiac output measurement inpatients undergoing liver transplantation:pulmonary artery catheter versus unealibrated arterial pressure waveform analysis［J］.Anesth Analg,2008,106:1480-1486.
[11]徐娜,兰飞,姚东旭,等.目标导向液体治疗对脊柱手术老年患者预后的影响［J］.临床麻醉学杂志,2018,34(7):647-650. XU N,LAN F,YAO DX,et al.Effects of goal-directed fluid therapy on the outcomes of elderly patients undergoing spinal surgery［J］.J Clin Anesthesiol,2018,34(7):647-650.
[12]陈炜佳,张树波,杨超杰,等.联合麻醉下目标导向液体治疗对炎症细胞因子的影响［J］.实用医学杂志,2018,34(4):604-608. CHEN WJ,ZHANG SB,YANG CJ,et al.Effects of goal-directed fluid therapy on inflammatory cytokines under combined anesthesia［J］.The Journal of Practical Medicine,2018,34(4):604-608.
[13]KULEMAN B，TIMME S，SEIFERT G，et al.Intraoperative crystalloid overload leads to substantial inflammation infiltration of intestinal anastomoses-a histomorphology analysis［J］.Surg(US),2013,154(3):596-603.
[14]MYLES PS，BELLOMO R，CORCORAN T，et al.Restrictive versus liberal fluid therapy for major abdominal surgery［J］.N Engl J Med,2018,378(24):2263-2274.
[15]孟改革,方卫平,张雷,等.目标导向液体治疗下晶体液与胶体液输注对肝切除术患者组织灌注和术后恢复的影响［J］.临床麻醉学杂志,2017,33(6):557-561. MENG GG,FANG WP,ZHANG L,et al.Effects of goal-directed fluid therapy filled with crystalliods or the recovery of tissue perfusion and postoperative recovery in patients undergoing hepatectomy［J］.J Clin Anesthesiol,2017,33(6):557-561.
[16]冯帅,肖玮,王天龙.目标导向液体治疗对小儿癫痫病灶切除术术后转归的影响［J］.北京医学,2018,40(6):513-516. FENG S,XIAO W,WANG TL.Effects of goal-directed fluid therapy on postoperative outcomes in children epilepsy surgery［J］.Beijing Medicine,2018,40(6):513-516.

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