Di-san junyi daxue xuebao (Mar 2022)
Fluid resuscitation with guidance of pulse pressure variability measured by continuous non-invasive arterial pressure monitor in postoperative hypovolemic patients: a prospective randomized controlled trial
Abstract
Objective To investigate the effectiveness of pulse pressure variability (PPV) measured by continuous non-invasive arterial pressure (CNAP) monitor in guidance of fluid resuscitation in postoperative hypovolemic patients. Methods A prospective randomized controlled trial was conducted on the postoperative hypovolemic patients admitted to Department of Intensive Care Unit of Fujian Provincial Hospital from August 2018 to August 2020. They were randomly divided into PPV group and central venous pressure (CVP) group, and fluid resuscitation targeted by PPV 0.05). The hemodynamic and tissue oxygen metabolism parameters were significantly improved as the goal of fluid resuscitation was arrived. No significant differences were seen in MAP, CI and PPV between the 2 groups after fluid resuscitation (all P>0.05), while CVP in the PPV group was significantly lower than that of the CVP group (P < 0.05). Compared with the CVP group, the ScvO2, DO2I, VO2I and ERO2 were increased significantly after fluid resuscitation in the PPV group (all P < 0.05), while Lac was decreased obviously in the PPV group (P < 0.05). Furthermore, the fluid resuscitation time and duration of mechanical ventilation were notably shortened, the cumulative fluid balance was remarkably decreased, and the incidence of cardiopulmonary complications was statistically reduced in the PPV group than the CVP group (all P < 0.05). Conclusion PPV measured by CNAP monitor can be used to guide the early fluid resuscitation in postoperative hypovolemic patients, which contributes to stabilizing the hemodynamic state more timely, improving the tissue oxygen metabolism, shortening the duration of mechanical ventilation, and reducing the risk of cardiopulmonary complications.
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