Effects Of Two Fluid Replacement Methods On Infants And Children Undergoing Lap Aroscopic Surgery

Objective:To investigate the effects of dynamic hemodynamics control infusion and traditional fluid replacement on intraoperative children during laparoscopic surgery.Methods:Children who underwent elective abdominal surgery were randomly divided into two groups.The experimental group used pulse pressure variability PPV as the main reference index to guide the infusion.The control group underwent rehydration according to the 421 rule,and adjusted the infusion rate according to the patient's vital signs..The experimental group recorded post-anesthesia induction(T1),intraoperative first hour(T2),intraoperative second hour(T3)abdomen(T4)at each time point of pulse pressure variability(PPV),invasive blood pressure,average Arterial(MAP),heart rate(HR),arterial lactic acid(Lac),central venous oxygen saturation(ScvO2)arteriovenous blood carbon dioxide partial pressure difference(Pcv-aCO2)and the total amount of intraoperative fluid in the child,urine volume,Blood loss,the control group recorded heart rate,blood pressure,mean arterial pressure,intraoperative urine volume,blood loss,total fluid intake,andcentral venous oxygen saturation(ScvO2)arteriovenous blood carbon dioxide partial pressure difference(Pcv-aCO2).Results:A total of 37 children were included,19 in the experimental group and 18 in the control group.There was no significant difference in age,height,weight,and operation time between the two groups.Compared with the control group,the liquid intake [(187.50±78.32)ml vs(252.60±87.91)ml ] and the crystal input: [(46.19±8.60)ml vs(53.16± 9.74)ml] were significantly different.The experimental group and the control group had different Pcv-aCO2[(6.87±1.93)mmHg vs(8.98±2.71)mmHg] and arterial lactic acid [(1.57±0.34)mmol/L vs(1.89±0.41)mmol/L ] at the T3 time(P <0.05).Conclusions: 1.Although it may be affected by intraoperative operations.However,pulse variability can dynamically reflect changes in patient volume and guide infusion in infant laparoscopic surgery.2.Liquid therapy guided by pulse pressure variability In the infant laparoscopic surgery,the amount of fluid can be used to maintain the patient's capacity stability.3.Infusion of excess fluid in infant laparoscopic surgery may result in decreased tissue oxygen exchange efficiency.