Goal Directed Fluid Therapy based on Stroke Volume Variation and Oxygen Delivery Index using Electrical Cardiometry in patients undergoing Scoliosis Surgery

Figures & data

Flow chart of patients

Figure 1. SVV and DO₂I-based protocol. SVVx: the threshold value for crystalloid bolus administration after turning patient to prone position (equals SVV measured at prone position + 20%). [30]

Figure 2. ROC curve for CI (before and after administration of the first fluid bolus to predict associated increase in CI ≥15% (n = 19) in group II

Table 1. Demographic data, duration of the operation, ASA status, and number of instrumental levels

	Group I (n = 24)			Group II (n = 24)			Test of sig.	p
	No.	%		No.		%
Gender
Male	9	37.5		8		33.3	χ^2 = 0.091	0.763
Female	15	62.5		16		66.7
Age (years)
Mean ± SD	21.08 ± 7.17			21.92 ± 7.73			U = 259.0	0.547
Median (min.–max.)	17.50 (15.0–38.0)			19.0 (15.0–43.0)
BMI (kg/m^2)
Min.–max.	20.0–31.0			21.0–31.0			t = 0.055	0.956
Mean ± SD	23.98 ± 2.96			24.02 ± 2.24
Duration of the operation (min)
Min.–max.	370.0–440.0			370.0–450.0			0.525	0.602
Min.–max.	396.3 ± 21.43			399.6 ± 22.55
ASA status
I	11		45.8	13	54.2		χ^2 = 0.333	0.564
II	13		54.2	11	45.8
Number of instrumental level
Min.– max.	6.0–10.0			6.0–10.0			t = 0.592	0.557
Mean ± SD	7.46 ± 1.28			7.25 ± 1.15

SD: Standard deviation.

χ²: chi-square test; t: Student’s t-test; U: Mann–Whitney test.

p: p value for comparing between the two studied groups.

Table 2. Correlation between SVV and CI in group II

CI	SVV
	r	p
Before 1	−0.571*	0.004*
Before 2	−0.415*	0.044*
Before 3	−0.683*	<0.001*
After 1	−0.510*	0.011*
After 2	−0.857*	<0.001*
After 3	−0.891*	<0.001*

r: Pearson coefficient. 1: the first fluid bolus administered. 2: the second fluid bolus administered.

*Statistically significant at p ≤ 0.05. 3: the third fluid bolus administered.

Table 3. Comparison between the two studied groups according to total blood loss (ml), intraoperative and postoperative units of packed RBCs and FFP transfused

	Group I (n = 24)	Group II (n = 24)	p
Total blood loss (ml)
Min.–max.	1900.0–2600.0	1200.0–1800.0	<0.001*
Mean ± SD	2247.9 ± 158.4	1447.9 ± 197.5
Units of packed RBCs transfused
Intraoperative
Mean ± SD	3.92 ± 0.65	2.25 ± 0.44	<0.001*
Median (min.–max.)	4.0 (3.0–5.0)	2.0 (2.0–3.0)
Postoperative
Mean ± SD	1.25 ± 0.44	0.42 ± .050	<0.001*
Median (min.–max.)	1.0 (1.0–2.0)	0.0 (0.0–1.0)
Units of FFP transfused
Intraoperative
Mean ± SD	5.04 ± 0.91	3.25 ± 0.44	<0.001*
Median (Min.–max.)	5.0 (4.0–7.0)	3.0 (3.0–4.0)
Postoperative
Mean ± SD	2.21 ± 0.51	0.42 ± 0.50	<0.001*
Median (Min.–max.)	2.0 (1.0–3.0)	0.0 (0.0–1.0)

SD: Standard deviation.

p: p value for comparing between the two studied groups.

*Statistically significant at p ≤ 0.05.

Bacchin MR, Ceria CM, Giannone S, et al. Goal-directed fluid therapy based on stroke volume variation in patients undergoing major spine surgery in the prone position: a cohort study. Spine (Phila Pa 1976). 2016;41(18):E1131–E1137. .

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