Influence of stroke volume variation on fluid treatment and postoperative complications in thoracic surgery

Abstract

Background

Fluid management in critically ill patients usually relies on increasing preload to augment cardiac output. In the present study, we aimed to evaluate whether stroke volume variation (SVV) can guide fluid therapy and reduce complications.

Patients and methods

In this retrospective study, a total of 88 patients who underwent lobectomy were divided into two groups: group 1 (SVV, n=43) and group 2 (conventional or central venous pressure [CVP], n=45). Heart rate, blood pressure, oxygen saturation, SVV (only group 1), CVP (all patients), urea, creatinine, and hemoglobin levels before and after surgery, use of fluid, blood and inotropic agents, and postoperative complications were recorded retrospectively.

Results

The mean age of the study population was 56.9±14.4 years and 75% of the patients were male. SVV was used in fluid therapy in 48.9% of the patients. The use of SVV resulted in an increased use of crystalloids and colloids with increased urine output per hour (p<0.05). Of patients in the SVV group and the CVP group, 44.1% and 51.1% developed at least one complication, respectively (p=0.531). The rate of respiratory complications including atelectasis, pneumonia, hypoxemia, and an increased production of secretions was 21% in the SVV group and 37.7% in the CVP group (p=0.104). The rate of complications and the length of hospital stay were comparable between the groups (p>0.05).

Conclusion

Our study results showed that the use of SVV increased the use of crystalloids and colloids and favorably affected urine output per hour but did not reduce complications in thoracic surgery.

Keywords:

• central venous pressure
• fluid management
• lobectomy
• one-lung ventilation
• stroke volume variation

Acknowledgments

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

Conception and design: CS, ET, SK. Acquisition of data: CS, ET, SK. Analysis and interpretation of data: CS, SK, FZA. Drafting the manuscript and revising it critically: CS, ET, SK, FZA. All authors read the manuscript and have given their final approval of the version for publication.

Disclosure

The authors report no conflicts of interest in this work.