Application of Corrected Left Ventricular Ejection Time and Stroke Volume Variability in Perioperative Volume Management Guiding Off-pump Coronary Artery bypass Grafting
WANG Wei-wei, REN Shao-yu, LIU Pan-pan
Shandong Provincial Third Hospital,Jinan Shandong,250031
Abstract：【Objective】To explore the application value of corrected left ventricular ejection time (LVETc) and stroke volume variability (SVV) in perioperative volume management guidance of off-pump coronary artery bypass grafting (OPCABG). 【Methods】A total of 66 patients with OPCABG were randomly divided into the observer group and the control group, with 33 cases in each group. The volume management was guided by LVETc in the observation group , and it was guided by SVV in the control group. The basic indexes (operation time, total rehydration volume, intraoperative urine volume, intraoperative blood loss, extubation time) of the two groups during the perioperative period were recorded. The hemodynamic indexes at different time points (mean arterial pressure, stroke volume index, heart rate, cardiac index, systemic vascular resistance) and oxygen kinetic indexes at different time points (oxygen supply index, oxygen consumption index, oxygen uptake rate) were measured in the two groups. In addition, the adverse reactions of the two groups were compared as well. 【Results】The total rehydration volume in the observation group was significantly lower than that that in the control group (P<0.05).The heart rate of the observation group was significantly lower than that of the control group when the pericardium was opened (T0) (P<0.05).The cardiac index of the observation group at T0 and T1 (left anterior descending branch bypass), was significantly lower than that of the control group(P<0.05).The systemic vascular resistance of the observation group at T0,T1, T2 (blunt edge branch bypass) and T3 (posterior descending branch bypass) was significantly higher than that of the control group (P<0.05).The oxygen supply index of the observation group was significantly lower than that of the control group at T1,T2 and T3 (P<0.05).The oxygen uptake rate of the observation group was significantly higher than that of the control group at T1,T2 and T3(P<0.05).The difference was not statistically significant in comparison of postoperative cardiovascular adverse reactions between the two groups (P>0.05). 【Conclusion】Taking LVETc as the guidance of volume management can reduce the total rehydration volume, improve the hemodynamics and oxygen kinetic indexes of patients. It reduces the fluid load in tissue space which is worthy of clinical promotion.
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2021, Vol. 38 
