Qiao Lanxin,Zhang Jianmin,Li Lijing,et al.Effect of goal-directed fluid therapy on the management and outcome of craniopharyngioma resection in children[J].Journal of Clinical Pediatric Surgery,,22():144-148.[doi:10.3760/cma.j.cn101785-202202018-009]
Effect of goal-directed fluid therapy on the management and outcome of craniopharyngioma resection in children
- Abstract:
- Objective To explore the effects of goal-directed fluid therapy (GDFT) guided by pulse pressure variability (PPV) on the management of craniopharyngioma resection,and the impact of outcome in children.Methods A total of 40 children aged 1-5 years with American Society of Anesthesiologists physical status Ⅱ-Ⅲ underwent elective craniopharyngioma resection.They were randomized into two groups of GDFT (group G) and conventional fluid treatment (group C).Intraoperative PPV-guided fluid infusion was offered in group G and traditional "4-2-1" fluid infusion in group C.Values of mean arterial pressure (MAP) and heart rate (HR) at the beginning of operation (T1),before dural incision (T2),at the end of operation (T3),intraoperative fluid status,utilization rate of antidiuretics and vasoactive agents,electrolyte status and postoperative hospital stay were recorded.Results At T3,HR was significantly higher in group C than that in group G[(96.1±22.4)bpm vs.(82.4±8.4)bpm] (P<0.05) and at T1[(96.1±22.4)bpm vs.(82.4±8.4)bpm].No significant inter-group difference existed in HR or MAP at other timepoints (P>0.05).In terms of fluid input/output,crystal fluid volume [(826.0±341.8)mL vs.(610.0±266.7)mL]and urine volume [(495.0±216.2)mL vs.(284.0±202.1)mL]were significantly higher in group G than those in group C (P<0.05) and the rest had no statistical significance.The incidence of electrolyte disturbance [0%(0/20) vs.25%(5/20)](K+) and postoperative hospitalization time [(8.6±1.8)d vs.(10.6±3.2)d]were significantly lower in group G than those in group C (P<0.05).No significant inter-group difference existed in intraoperative utilization rate of antidiuretics [5%(1/20) vs.5%(1/20)]and vasoactive agents [0%(0/20) vs.5%(1/20)]or operative duration [(324.8±47.7)min vs.(328.0±68.0)min](P>0.05).Conclusion In children undergoing elective craniopharyngioma resection,PPV-guided GDFT may maintain the stability of intraoperative hemodynamics,reduce the incidence of postoperative electrolyte disorders and shorten postoperative hospitalization stay.
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Memo
收稿日期:2021-11-27。
通讯作者:张建敏,Email:zjm428@sina.com