Effects of intraoperative fluid management on hemodynamics and tissue oxygenation according to the Pleth Variability Index in thoracic surgery.

Abstract

Background: The aim of this study was to compare the total fluid volume performed by noninvasive Pleth Variability Index in thoracic surgery patients in comparison to conventional fluid management.

Methods: In this prospective randomized controlled study conducted between May 2019 and May 2020, 80 patients (68 males, 12 females; mean age: 58.5±6.7 years; range, 18 to 65 years) were divided into two groups: control (Group C) and the Pleth Variability Index (Group P). After performing routine anesthesia and Pleth Variability Index monitoring for all patients, fluids were given at a rate of 2 mL/kg/h with the standard anesthesia technique. Additional fluid supplementation was provided based on hemodynamic data in Group C. In Group P, 250 mL bolus crystalloid fluid was provided when Pleth Variability Index was >14%. Mean arterial pressure, heart rate, oxygen saturation, arterial blood gas, and blood biochemistry were recorded. Total fluid volumes and urinary output were also recorded.

Results: There was no significant difference between the groups in terms of total fluid volumes or urinary output. In the postoperative period, the oxygen saturation and mean arterial pressure of Group P were found to be higher than those of Group C. The postoperative creatinine and lactate values of Group P were lower than those of Group C.

Conclusion: Although there was no significant difference in the total fluid given to the patients, fluid management by Pleth Variability Index monitoring had a positive effect on mean arterial pressure, oxygen saturation, lactate, and creatinine levels.