The Effects Of Goal-Directed Fluid Therapy On Cardiac Function In Patients With Gastrointestinal Surgery

Objectives To observe the effects of goal-directed fluid therapy on cardiac function in patients with gastrointestinal surgery.Methods Sixty ASA? or ? patients with gastrointestinal surgery were randomly divided into two groups: thirty in experimental group(group A) and thirty in the control group(group B). Group A were applied with goal-directed fluid therapy based on stroke volume variation(SVV), cardiac index(CI), stroke volume index(SVI), and group B were applied with conventional liquid infusion based on CVP and MAP. All patients were received continuous monitoring with ECG, HR, MAP, CVP and SPO2. Cardiac output(CO),cardiac index(CI) and arterial blood gas were monitored before anesthesia(T1), at the onset of surgery(T2), one hour after onset of surgery(T3) and the end of surgery(T4).Venous blood samples were collected at those four time points to examine the contents of atrial natriuretic peptide(ANP) and cardiac troponin I(cTnI).Results Compared with those of group B and group A, intraoperative intravenous infusion quantity was significantly reduced[(966±222)vs(1356±244)ml, P?0.05], while its colloid fluid volume was larger[(1272±189)vs(983±202)ml, P ? 0.05],and its urine volume was larger, too[(428±54)vs(359±66)ml, P ? 0.05]. Intraoperative and postoperative hemodynamics was more stable, compared with group B, MAP and CVP were larger in group A at T2-T4(P?0.05). CI, SVI, CO were larger in group A than in group A at T2-T4( P?0.05). The levels of atrial natriuretic peptide(ANP) and Cardiac Troponin I(cTnI) in group A were lower than the controls at T2-T4(P?0.05).Conclusions Goal-directed fluid therapy can maintain hemodynamic stability, reduce perioperative myocardial damage and protect the patient's heart function.