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Effects of different methods of volume therapy on inflammatory response in patients undergoing liver cancer resection / 中华麻醉学杂志
Chinese Journal of Anesthesiology ; (12): 477-480, 2012.
Artículo en Chino | WPRIM | ID: wpr-426998
ABSTRACT
Objective To investigate the effects of different methods of volume therapy on the inflammatory response in patients undergoing liver cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients,aged 40-60 yr,with body mass index 20-25 kg/m2,undergoing liver cancer resection,were randomly divided into 2 groups ( n =20 each)routine fluid replacement group (group Ⅰ ) and goal-directed fluid replacement group (group Ⅱ ).The fluid replacement regime in group Ⅰ =compensatory volume expansion (CVE) + physiological requirements + cumulative loss + confinued loss + the third space losses.CVE was replaced with lactated Ringer's (LR) solution 5 mg/kg before anesthesia induction.The physiological requirements and cumulative loss were replaced with LR solution according to the principle of 4-2-1.The continued loss equal to the intraoperative blood loss was replaced with the equal volume of 6% hydroxyethyl s tarch ( HES 130/0.4).The 3rd space losses were replaced with LR solution 5 ml·kg-1 ·h-1.In group Ⅱ,CVE was replaced with LR sol6ution as in group Ⅰ.LR solution was infused after anesthesia induction at 5 ml·kg-1 ·h-1.6% HES was infused to maintain left ventricular ejection time (LVETc) between 350-400 ms.When 350 ms < LVETc < 400 ms and the amplitude of stroke volume ( SV ) increased by > 10%,6% HES was infused continuously until the amplitude of SV increased by ≤ 10%.Blood samples were taken before anesthesia induction and at the end of operation for measurement of serum TNF-α,IL-2,IL-4,IL-6 and IL-8 concentrations.The adverse cardiovascular reactions were recorded.Results Compared with group Ⅰ,the serum TNF-α,IL-6,IL-8 concentrations were significantly decreased,the serum IL-2 and IL-4 concentrations were significantly increase,and the incidence of hypotension and tachycardia was significantly decreased in group Ⅱ ( P < 0.05).No adverse cardiovascular reactions were found in both groups.Conclusion LVETc and SV-guided volume therapy can maintain the blood volume and inhibit the inflammatory response and is suitable for the patients undergoing liver cancer resection.

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Idioma: Chino Revista: Chinese Journal of Anesthesiology Año: 2012 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Idioma: Chino Revista: Chinese Journal of Anesthesiology Año: 2012 Tipo del documento: Artículo