Original scientific paper
https://doi.org/10.3325/cmj.2015.56.290
Intraoperative volume restriction in esophageal cancer surgery: an exploratory randomized clinical trial
Maja Karaman Ilić
orcid.org/0000-0001-5383-8331
; Department of Anesthesiology University Hospital Centre Zagreb, Zagreb, Croatia
Goran Madžarac
; Department of Thoracic Surgery “Jordanovac,” University Hospital Centre Zagreb, Zagreb, Croatia
Jana Kogler
; Department of Anesthesiology University Hospital Centre Zagreb, Zagreb, Croatia
Dinko Stančić-Rokotov
; Department of Thoracic Surgery “Jordanovac,” University Hospital Centre Zagreb, Zagreb, Croatia
Nevenka Hodoba
; Department of Anesthesiology University Hospital Centre Zagreb, Zagreb, Croatia
Abstract
Aim To investigate whether the fluid volume administered
during esophageal cancer surgery affects pulmonary gas
exchange and tissue perfusion.
Methods An exploratory single-center randomized clinical
trial was performed. Patients with esophageal cancer
who underwent Lewis-Tanner procedure between June
2011 and August 2012 at the Department of Thoracic surgery
“Jordanovac”, Zagreb were analyzed. Patients were
randomized (1:1) to receive a restrictive volume of intraoperative
fluid (≤8 mL/kg/h) or a liberal volume (>8 mL/kg/h).
Changes in oxygen partial pressure (Pao2), inspired oxygen
fraction (FiO2), creatinine, and lactate were measured during
and after surgery.
Results Overall 16 patients were randomized and they
all were analyzed (restrictive group n = 8, liberal group
n = 8). The baseline value Pao2/FiO2 ratio (restrictive) was
345.01 ± 35.31 and the value six hours after extubation was
315.51 ± 32.91; the baseline Pao2/FiO2 ratio (liberal) was
330.11 ± 34.71 and the value six hours after extubation was
307.11 ± 30.31. The baseline creatinine value (restrictive)
was 91.91 ± 12.67 and the value six hours after extubation
was 100.88 ± 18.33; the baseline creatinine value (liberal)
was 90.88 ± 14.99 and the value six hours after extubation
was 93.51 ± 16.37. The baseline lactate value (restrictive)
was 3.93 ± 1.33 and the value six hours after extubation
was 2.69 ± 0.91. The baseline lactate value (liberal) was
3.26 ± 1.25 and the value six hours after extubation was
2.40 ± 1.08. The two groups showed no significant differences
in Pao2/FiO2 ratio (P = 0.410), creatinine (P = 0.410), or
lactate (P = 0.574).
Conclusions Restriction of intraoperative applied volume
does not significantly affect pulmonary exchange function
or tissue perfusion in patients undergoing surgical treatment
for esophageal cancer.
Keywords
Hrčak ID:
151333
URI
Publication date:
15.6.2015.
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