Usefulness of Monitoring Stroke Volume Variations for Fluid Management During Pediatric Living-Donor Liver Transplantation

作     者：Yoshihiro Kasagi Manabu Hashimoto Shugo Kasuya Seisuke Sakamoto Mureo Kasahara Yasuyuki Suzuki Eiichi Inada 

作者机构：Department of Anesthesia and Intensive Care National Center for Child Health and Development Okura Setagaya-ku Tokyo Japan Department of Anesthesiology and Pain Medicine Juntendo University School of Medicine Hongo Bunkyo-ku Tokyo Japan Transplantation Surgery National Center for Child Health and Development Okura Setagaya-ku Tokyo Japan 

出 版 物：《Open Journal of Anesthesiology》 (麻醉学期刊（英文）)

年 卷 期：2012年第2卷第4期

页      面：146-149页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Pediatric Living-Donor Liver Transplantation Fluid Management Stroke Volume Variation Reperfusion 

摘      要：Purpose: Central venous pressure (CVP) is considered to be unsuitable as preload parameter. Stroke volume variation (SVV) has recently been reported to be effective as a preload and fluid responsiveness parameter, and its usefulness for fluid management during living-donor liver transplantation (LDLT). However, use of SVV has not been reported in children. Our aim is to evaluate the use of SVV as a target parameter of circulating blood volume during pediatric LDLT. Methods: This retrospective study was conducted in 40 consecutive patients aged between 5 and 109 months who underwent elective LDLT. Twenty patients underwent LDLT without FloTrac? (C group) and the rest patients underwent LDLT with the FloTrac? monitoring (F group). As a fluid management target, CVP was maintained at 10 mmHg in the C group and SVV at 10% in the F group. We compared MAP and CVP at the times of the greatest decrease within 5 minutes after reperfusion. Results: MAP after reperfusion was significantly decreased in both groups (P 0.01), with the magnitude of decrease significantly greater in the C group compared with the F group (P = 0.02). MAP before and after reperfusion did not significantly differ between the groups. After reperfusion, CVP was nearly the same in both groups, with that in the C group slightly decreased and nearly no change in the F group. SVV after reperfusion was significantly increased (P 0.001). Conclusion: When used as a target parameter for fluid management during pediatric LDLT, hemodynamic changes was less when SVV was used as the parameter of circulating blood volume.