caa a22 4500 605509522 CHVBK 20210128100641.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10877-014-9567-5 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9567-5 Pleth variability index-directed fluid management in abdominal surgery under combined general and epidural anesthesia [Elektronische Daten] [Yinan Yu, Jing Dong, Zifeng Xu, Hao Shen, Jijian Zheng] Pleth variability index (PVI), a noninvasive dynamic indicator of fluid responsiveness has been demonstrated to be useful in the management of the patients with goal directed fluid therapy under general anesthesia, but whether PVI can be used to optimize fluid management under combined general and epidural anesthesia (GEN-EPI) remains to be elucidated. The aim of our study was to explore the impact of PVI as a goal-directed fluid therapy parameter on the tissue perfusion for patients with GEN-EPI. Thirty ASA I-II patients scheduled for major abdominal surgeries under GEN-EPI were randomized into PVI-directed fluid management group (PVI group) and non PVI-directed fluid management group (control group). 2mL/kg/h crystalloid fluid infusion was maintained in PVI group, once PVI>13%, a 250mL colloid or crystalloid was rapidly infused. 4-8mL/kg/h crystalloid fluid infusion was maintained in control group, and quick fluid infusion was initiated if mean arterial blood pressure (BP)<65mmHg. Small doses of norepinephrine were given to keep mean arterial BP above 65mmHg as needed in both groups. Perioperative lactate levels, hemodynamic changes were recorded individually. The total amount of intraoperative fluids, the amount of crystalloid fluid and the first hour blood lactate levels during surgery were significantly lower in PVI than control group, P<0.05. PVI-based goal-directed fluid management can reduce the intraoperative fluid amount and blood lactate levels in patients under GEN-EPI, especially the crystalloid. Furthermore, the first hour following GEN-EPI might be the critical period for anesthesiologist to optimize the fluid management. Springer Science+Business Media New York, 2014 Pleth variability index nationallicence Goal directed fluid therapy nationallicence Combined general and epidural anesthesia nationallicence Fluid management nationallicence Blood lactate acid nationallicence Crystalloid fluid nationallicence Yu Yinan Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut Dong Jing Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut Xu Zifeng Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut Shen Hao Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut Zheng Jijian Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/1(2015-02-01), 47-52 1387-1307 29:1<47 2015 29 10877 https://doi.org/10.1007/s10877-014-9567-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9567-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yu Yinan Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut NATIONALLICENCE 700 1- Dong Jing Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut NATIONALLICENCE 700 1- Xu Zifeng Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut NATIONALLICENCE 700 1- Shen Hao Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut NATIONALLICENCE 700 1- Zheng Jijian Department of Anesthesiology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai, China aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/1(2015-02-01), 47-52 1387-1307 29:1<47 2015 29 10877