Feasibility Analysis Of FloTrac/Vigileo System For Single Lung Ventilation Hemodynamic Monitoring

Objective To compare the FloTrac/Vigileo system and transesophageal echocardiography?transesophageal,echocardiography,TEE?for the hemodynamic relevance in patients undergoing one lung ventilation,to investigate the feasibility of FloTrac/Vigileo in one lung ventilation for hemodynamic monitoring.Methods 25 cases of patients undergoing pulmonary resection under general anesthesia has be selected,who's age at 18⁶5,American Society of anesthesiologists?American society of Anesthesiologists,ASA?I^II grade,gender is not limited,preoperative ECG examination showed no arrhythmia and no contraindications to application of transesophageal echocardiography.The radial artery puncture catheter was connected to the FloTrac/Vigileo monitoring system sensor,and was inserted into the transesophageal ultrasound probe after general anesthesia induction.All patients were induced by the same narcotic drugs and the same methods of general anesthesia.The bispectral index?bispectral index,BIS?was used to monitor intravenous anesthesia depth during operation,and the depth of venous anesthesia was adjusted according to the BIS numerical value.Using FloTrac/Vigileo and TEE monitoring system to collect and record stroke volume?stroke volume,SV?,cardiac output?cardiac output,CO?,stroke volume variation?stroke volue variation,SVV?or collapse index of vena cava inferior?collapse index of vena cava inferior,cIVC?and other hemodynamic parameters,while recording the heart rate?heart rate,HR?in the following 6 time points:T₀:after anesthesia intubation and in the lateral position?before open the chest?;T₁:begin one lung ventilation;T₂:one lung ventilation for 15min;T₃:one lung ventilation for 30min;T_4:one lung ventilation for 45min;T₅:one lung ventilation for 60min.The SV and CO measured by the FloTrac/Vigileo system denoted as SV_F,CO_F;SV and CO measured by TEE denoted as SV_T,CO_T.The relevance between the hemodynamic parameters measured by FloTrac/Vigileo system and the parameters of transesophageal echocardiography are analyzed.To clear whether the FloTrac/Vigileo system is suitable for patients with one lung ventilation.Results 1?The correlation analysis between SV_F and SV_T was positive,and the correlation coefficient r=0.84,P<0.01.The correlation analysis between CO_F and CO_T was positive,and the correlation coefficient r=0.92,P<0.01.2?Compared with SV_T,there was no statistical significance with SF_T in the T₀^T₅ each points?P>0.05?.Compared with CO_T,CO_F shows no significant difference at each time point in T₀^T₅?P>0.05?.3?Compared with T₀?before open the chest?,SV_F,SV_T,CO_F,CO_T had no significant difference at T₁?after open the chest and in one lung ventilation??P>0.05?.4?The correlation analysis between SVV and cIVC was positive,and the correlation coefficient r=0.80,P<0.01.The linear regression equation of SVV and cIVC is cIVC=18.09+2.88SVV.Regression coefficient b=2.88,the regression analysis results showed a statistically significant difference?P<0.05?;Compared with T₀?before open the chest?,SVV and cIVC had no significant difference at T₁?after open the chest and in one lung ventilation??P>0.05?.5?Correlation analysis was performed on SV_F and SV_T,CO_F and CO_T,SVV and cIVC at each time point,the results showed that there was a positive correlation between the hemodynamic parameters of the three groups at each time point of T₁^T₅,and the difference was statistically significant?P<0.05?.However,there was no significant correlation between the hemodynamic parameters of the three groups at T₀,and the difference was not statistically significant?P>0.05?.Conclusion The clinical value of FloTrac/Vigileo system monitoring SV,CO,SVV and other hemodynamic parameters,which is similar to TEE in patients with one lung ventilation surgery.The FloTrac/Vigileo system can replace TEE in thoracic surgery as a method of hemodynamic monitoring during the operation.It must be noted,however,that there may be a bias in the monitoring of hemodynamic,when the fluctuations in hemodynamics sharply.So when there is severe hemodynamic fluctuations,should be combined with other clinical monitoring index,comprehensive analysis and judgment,to avoid excessive dependence on the monitoring results of FloTrac/Vigileo system and lead to a miscarriage of justice.