Application effect of goal-directed fluid therapy guided by stroke volume variability in patients undergoing septic shock surgery
XU Liang
BIAN Qinghu
MENG Lijiang
ZHANG Shan
ZHANG Zhiqiang
Abstract：Objective To observe the application effect of goal-directed fluid therapy(GDFT)guided by stroke vol-ume variability(SVV)in patients during septic shock surgery.Methods Sixty patients undergoing septic shock surgery were randomly divided into the GDFT group and conventional treatment group(control group),with 30 cases in each group.GDFT group was connected with flotrac/vigileo monitor to monitor SVV,and target-directed fluid therapy was performed ac-cording to the changes of SVV;the control group was connected with a common sensor to monitor the invasive arterial blood pressure,and the traditional infusion scheme was used for volume treatment.The intraoperative fluid intake and output,the dosage of vasoactive drugs,the internal jugular vein bulb oxygen saturation(SjvO2),arterio-venous oxygen content differ-ence(Da-jvO2),cerebral oxygen uptake(CERO2),lactate clearance rate(LCR)and S100β levels before anesthesia induc-tion(T0),before the beginning of surgery(T1),1 h after the beginning of surgery(T2)and at the end of surgery(T3)were compared between the two groups,as well as the MMSE scores,postoperative ICU stay and hospital stay.Results The to-tal volume of infused fluid in the GDFT group was lower than that in the control group(P<0.05).There were no significant differences in blood loss,urine volume or dosage of vasoactive drugs between the two groups(all P>0.05).SjvO2 and LCR in the two groups increased at T1,T2,and T3 compared with T0,and the increasing trend of the GDFT group was greater than that of the control group(all P<0.05);the Da-jvO2 and CERO2 in the two groups decreased at T1,T2,and T3 compared with T0,and the decreasing trend in the GDFT group was greater than that in the control group(all P<0.05);S100 β levels in the two groups were lower at T1,T2,and T3 than at T0(all P<0.05),and S100 β levels in the GDFT group were lower at T1,T2,and T3 than those in the control group(all P<0.05).There were no significant differences in MMSE score,ICU stay time and hospital stay between the two groups at 1,3 and 7 d after operation(all P>0.05).Conclusion GDFT guided by SVV can help optimize intraoperative fluid management during septic shock surgery,improve cerebral oxygen metabolism,improve lactate clearance rate,reduce S100β protein level,and play a role in brain protection.
Keywords：septic shockstroke volume variabilitygoal-directed fluid therapycerebral oxygen metabolism ratelactate clearance rate
Publication Date：2025-09-25
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：6( 46-50,55 )