A New Preoperative Ultrasound Evaluation For Optimal Capacity Management Of Emergency Surgery Patients:a Randomized Controlled Clinical Study

Objective:To explore whether compared with the conventional method for preoperative volume assessment in emergency surgery,the pioneering preoperative ultrasound assessment of the SHEN YI integral method can guide the fluid treatment program quickly and accurately and improve circulatory stability.Methods:60 patients who underwent emergency general anesthesia surgery from September 1,2020 to December 31,2020 in Shenzhen People’s Hospital were selected and randomly divided into the experience group and the ultrasound group,with 30 cases in each group.In the experience group,patients’ volume status were assessed through indicators such as blood pressure,heart rate,and the fluid supplementation for patients was based on the personal experience of the anesthesiologist.In the ultrasound group,the anesthesiologist scaned 3 sections by ultrasound so that different scores could be pointed according to the preset tables in order to determine blood volume condition of patients and choose different rehydration solutions.Recording all the information during the surgery.Results:The main outcome indicator of this study was the stability of the circulatory blood pressure of the two groups of patients,which was mainly reflected in the comparison of the average arterial pressure at different times.The difference in mean arterial pressure at the beginning of surgery between the two groups was statistically significant(P=0.003*),while the differences in mean arterial pressure at other time was not statistically significant(P>0.05).Among the secondary outcome indicators,the difference in hematocrit(Hct)between the two groups of patients at the end of surgery was statistically significant(P=0.014*),and there were no statistically significant differences in heart rate,blood oxygen saturation,p H,hemoglobin(Hb)and lactic acid values(Lac)at different times.There were also no statistically significant differences in the types and doses of vasoactive drugs,the number of days of hospitalization,postoperative complication rate and the health scores of 30 days after surgery(P>0.05).The mortality rate within 30 days after surgery is zero.The general data comparison was that the difference in the type of fluid used within 30 minutes after selecting the rehydration regimen between the experience group and the ultrasound group was statistically significant(P =0.036*).The differences in other basic conditions were not statistically significant(P>0.05).Conclusions:To some extent,The preoperative ultrasound assessment of the SHEN YI integral method has effects on the optimal management of emergency patients’ capacity,which can effectively and accurately assess the patient’s cardiac function and volume status,as well as better guide perioperative fluid management.Compared with the conventional volume assessment empirical method,SHEN YI method’s effect of improving the patient’s capacity reserve in the initial stage of the operation is better,and it can maintain circulatory stability,making the patient pass the initial stage of the operation smoothly.But SHEN YI method has no obvious effect on the middle and late stages of the operation and the postoperative recovery.The preoperative ultrasound evaluation of SHEN YI integral method is intuitive,easy to learn,and low in price.It is expected to be promoted to the clinic after further optimization and larger sample size research improving its effectiveness and accuracy.