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

Figures & data

Figure 1 CONSORT 2010 flow diagram.

Abbreviations: CVP, central venous pressure; SVV, stroke volume variation.

Table 1 Demographic characteristics of patients

Characteristic	All patients (n=88)	SVV group (n=43)	CVP group (n=45)	p-value
Age (years)	61 (20–78)	61 (20–78)	61 (20–73)	0.864
Gender (F/M)	22/66	8/35	14/31	0.221
BMI (kg/m^2)	25.9±4	25.6±3.9	26.1±4.1	0.555
BSA (m^2)	1.8±0.2	1.8±0.2	1.8±0.2	0.992
Smoking (no/yes)	24/64	9/34	15/30	0.235
Comorbidities (no/yes)	35/53	19/24	16/29	0.538
FEV1 (%)	87.7±17.6	88.7±17.4	86.8±18	0.615
FVC (%)	96.5±16.6	96.1±16	96.8±17.4	0.860
FEV1/FVC (%)	74.2±9.7	75.2±9.3	73.1±10.1	0.308
Side of operation (right/left)	54/34	24/19	30/15	0.382

Note: Data are expressed as mean ± standard deviation, median (minimum–maximum), or number of cases.

Abbreviations: BMI, body mass index; BSA, body surface area; CVP, central venous pressure; F, female; FEV₁, forced expiratory volume in 1 sec; FVC, forced vital capacity; M, male; SVV, stroke volume variation.

Table 2 Intraoperative baseline values of patients

Characteristic	All patients (n=88)	SVV group (n=43)	CVP group (n=45)	p-value
MAP (mmHg)	85±13	82±13	87±13	0.075
Heart beat (bpm)	90±16	88±16	92±16	0.252
CVP (mmHg)	8±2.6	7.5±2.8	8.5±2.2	0.060
Oxygen saturation (%)	98.5±0.9	98.7±0.8	98.4±1	0.075
Lactate (mmol/L)	1.2±0.5	1.1±0.5	1.2±0.5	0.286
Hemoglobin (g/dL)	13.4±1.3	13.2±1.1	13.6±1.5	0.178
Urea (mg/dL)	33±10	33±10	34±10	0.527
Creatinine (mg/dL)	0.84±0.19	0.85±0.2	0.83±0.18	0.737

Note: Data are expressed as mean ± standard deviation.

Abbreviations: CVP, central venous pressure; MAP, mean arterial pressure; SVV, stroke volume variation.

Table 3 Postoperative values of patients

Characteristic	All patients (n=88)	SVV group (n=43)	CVP group (n=45)	p-value
MAP (mmHg)	84±16	87±17	81±14	0.059
Heart rate (bpm)	75±15	75±16	75±13	0.851
CVP (mmHg)	9.2±3.6	8.3±4.1	10.1±2.9	0.022
Oxygen saturation (%)	98.4±1.2	98.7±1.1	98.1±1.2	0.075
Lactate (mmol/L)	1.59±0.71	1.53±0.64	1.62±0.74	0.611
Hemoglobin (g/dL)	11.4±1.4	11.5±1.2	11.3±1.6	0.409
Urea (mg/dL)	38.5±14	40±16	37±12	0.450
Creatinine (mg/dL)	0.85±0.3	0.87±0.3	0.83±0.3	0.579

Notes: Data are expressed as mean ± standard deviation. Bold data are significant at p<0.05.

Abbreviations: CVP, central venous pressure; MAP, mean arterial pressure; SVV, stroke volume variation.

Table 4 Hemodynamic parameters of the SVV group

Measurement time	MAP (mmHg)	CVP (mmHg)	SVV (%)	SVI (mL/m^2)	CI (L/min/m^2)
Baseline	82±13	7.2±3.3	10.5±3.5	37.8±10.6	3.3±0.8
After volume loading	82±16	8.3±3.7**	10.4±4.5	37.4±9.7	3.1±0.9
OLV 15 min	75±10*	9.3±3.7**	9.5±3.8	40±9.6+	3±0.8#
OLV 60 min	75±13*	9.2±3.8**	8.9±3.8	39.5±10.6+	2.7±0.6#
Closed thorax	86±16	8.7±4.4**	12.2±5.3***	43.4±11.8+	3.1±0.8

Notes: Data are expressed as mean ± standard deviation.

* MAP values in OLV are lower than in other periods (p<0.05).

** CVP values were significantly higher after fluid loading (p<0.05).

*** SVV was elevated when the thorax was closed (p=0.001).

+ SVI was increased in OLV (p=0.012) and closed thorax (p=0.035).

# CI was decreased in OLV 15 min (p=0.021) and OLV 60 min (p<0.001) compared to basal values.

Abbreviations: CI, cardiac index; CVP, central venous pressure; MAP, mean arterial pressure; OLV, one-lung ventilation; SVI, stroke volume index; SVV, stroke volume variation.

Table 5 Intraoperative values of patients

Characteristic	All patients	SVV group	CVP group	p-value
Time to extubation (min)	11 (4–25)	15 (5–25)	10 (4–25)	0.556
One-lung ventilation time (min)	139±64	151±72	128±55	0.100
Operation time (min)	242±67	254±66	231±67	0.109
Length of hospital stay (days)	6 (3–22)	6 (3–12)	6 (3–22)	0.161
Crystalloid (mL)	1,200 (300–2,300)	1,500 (350–2,300)	1,000 (300–2,000)	<0.001
Colloid (mL)	100 (0–1,000)	150 (0–1,000)	50 (0–500)	0.005
Urine (mL/kg/h)	0.65 (0.2–3)	0.76 (0.2–3)	0.6 (0.2–1.3)	0.009
Use of inotropic agent (yes/no)	8/80	4/39	4/41	0.946
Use of blood products (yes/no)	8/80	5/38	3/42	0.479

Notes: Data are expressed as mean ± standard deviation, median (minimum–maximum), and number of cases. Bold data are significant at p<0.05.

Abbreviations: CVP, central venous pressure; SVV, stroke volume variation.

Table 6 Postoperative complications

Complications	All patients (yes/no)	SVV group (yes/no)	CVP group (yes/no)	p-value
All complications	41/47	18/25	23/22	0.402
Respiratory complications	26/62	9/34	17/28	0.104
Increased secretions	12/76	4/39	8/37	0.354
Atelectasis	14/74	5/38	9/36	0.385
Pneumonia	7/81	2/41	5/40	0.435
Hypoxemia	5/83	4/39	1/44	0.198
Air leak >5 days	8/80	3/40	5/40	0.714
Cardiac complications	5/83	4/39	1/44	0.198
Acute renal failure	3/85	1/42	2/43	>0.999

Notes: Data are expressed as number of cases. Some patients had more than one complication.

Abbreviations: CVP, central venous pressure; SVV, stroke volume variation.