Exp Physiol. 2021 Aug 4. doi: 10.1113/EP089348. Online ahead of print.
ABSTRACT
NEW FINDINGS: What is the central question of the study? Massive infusion can destroy the endothelial glycocalyx (EG). We compared the serum concentrations of EG components, atrial natriuretic peptide (ANP), and the outcomes of patients with different levels of stroke volume variation (SVV). What is the main finding and its importance? With a decrease in SVV, the serum concentrations of EG components and ANP increased, while the oxygenation index decreased. When the intraoperative SVV was maintained at 7-10%, the patients had better postoperative recovery and shorter postoperative hospital stays. Therefore, it is better to maintain the SVV value between 7% and 10%.
ABSTRACT: Dynamic hemodynamic parameters, such as stroke volume variation (SVV), can be used for volume monitoring. However, studies have only determined the SVV threshold but not the optimal level. The endothelial glycocalyx (EG) plays an important role in maintaining vascular permeability. Moreover, rapid and massive infusion can lead to the degradation, shedding, and destruction of the EG. We aimed to explore the effects of different SVV values (11-14%, 7-10%, or 3-6%) on the EG in 54 patients who were scheduled for elective colorectal tumour surgery and identify the optimal perioperative fluid therapy strategy. The concentrations of EG degradation products (heparin sulphate, hyaluronic acid, syndecan-1) and atrial natriuretic peptide (ANP) were higher when the SVV was maintained between 3% and 6% after fluid therapy compared to before infusion (p < 0.05). Comparison of postoperative complications and hospitalisation time among the three SVV levels was not statistically significant (p >0.05). The postoperative hospitalisation time in group M was shorter than that in group L. When the SVV was maintained between 7% and 10%, patients had shorter postoperative recovery time compared to patients whose SVV was maintained at other levels. High fluid volume with increasing EG degeneration and ANP levels may be related to postoperative outcomes. This article is protected by copyright. All rights reserved.
PMID:34347918 | DOI:10.1113/EP089348
