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Application of ultrasound in goal-directed fluid management of anesthesia in elderly patients

Objective: To investigate the effect of ultrasonography in goal-directed fluid management of anesthesia in elderly patients.

Methods: A total of 232 elderly patients with general anesthesia were selected from North China University affiliated Hospital from October 2012 to October 2014. These patietns were assigned into two groups by random digital table method. One hundred and sixteen patients who received goal-directed fluid management with guidance of central venous pressure (CVP) were assigned into control group. One hundred and sixteen patients who received goal-directed fluid management with guidance of ultrasonography were assigned into observation group. The effect of ultrasonography was compared between two groups.

Results: Cardiac index (CI), stroke volume variation (SVV), mean arterial pressure (MAP), central venous pressure (CVP), central venous oxygen saturation (ScvO2), oxygen supply index (DO2I), oxygen consumption index (VO2I), oxygen uptake rate (ERO2) were higher in observation group than control group at T1, T2, T3, T4 ,P<0.05. Lactate (Lac) were lower in observation group than control group at T1, T2, T3, T4, P<0.05. Urine volume and colloid fluid volume were higher in observation group than control group, P<0.05. Crystal liquid volume and total input were lower in observation group than control group, P<0.05. The incidence of complication was lower in observation group than control group, P<0.05.

Conclusion: In goal-directed fluid management, the guidance of ultrasonography is beneficial for stabilization of hemodynamic and metabolic markers in elderly patients, this could effectively maintain oxygen balance. The guidance of ultrasonography could also guarantee microcirculation perfusion.

Author(s): Baoyong Li, Limin Zhang, Shubo Zhang, Baohua Wang