Clinical Observition Of Arterial Pressure-based Cardiac Output (apco) Monitoring For Assessment Of Perioperative Volume Management Undergoing Cerebral Tumer Surgery

OBJECTIVE:To study the clinical efficacy of arterial pressure-based cardiac output(APCO) for assessment of perioperative volume management undergoing cerebral turner surgery.METHODS:A total of 40 ASA I or II patients undergoing elective cerebral tumer surgery were randomly divided into tow groups: conventional group (group C, n=20) and APCO group (group A, n=20).The patients of group C were monitored with heart rate(HR), mean arterial pressure(MAP) and central venous pressure(CVP) to adjust fluid infusion rate; The patients of group A were monitored with hemodynarnic indexes of APCO including cardiac output(CO), cardiac index(CI), stroke Volume(SV) and stroke volume variation(SVV) to maintaine CI>2.5L/min/m2 and SVV < 13% to adjust fluid infusion rate. Heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),central venous oxygen saturation(ScvO2) and blood lactate concentration of two groups were recorded after induction of anesthesia(T1), the tumor excision(T2) and the end of surgery(T3). CI and SVV of group A were monitored at T1, T2 and T3,while the oxygen delivery index(DO2I) and systemic vascular resistance index(SRVI) of group A were calculated at T1, T2 and T3 too.The operation time,the total of blood loss,infusion and urine of tow groups were counted.RESULTS:1.There were no significant differences in HR, MAP and CVP of two groups(P>0.05).There were no significant difference in SVV and SRVI of group A at T1, T2 and T3(P>0.05),but CI and DO2I of group A increased at T3 as compared with that at T1(P<0.05).2.There were no significant differences in blood gas analysis parameters of two groups at T1, T2 and T3(P>0.05).3.There were no significant differences in ScvO2 and blood lactate concentration of two groups at T1, T2 and T3(P>0.05).4.There were no significant differences in the operation time, the total of blood loss and urine of tow groups at T1, T2 and T3(P>0.05).but the total of infusion of group A were decreased obviously compared with that of group C(P< 0.05).CONCLUSIONS:1.Perioperative hemodynamic indexes are steady with two methods to guide volume management of patients undergoing cerebral turner surgery,but it can get rich monitoring indicators by APCO. 2.The tissue oxygenation and microcirculatory perfusion are sufficient in both groups.3.The fluid therapy is more accurate by APCO guidance.