Transesophageal Doppler monitoring for fluid therapy in patients undergoing major abdominal surgery

Abstract

Objective To investigate the significance of transesophageal Doppler monitoring for fluid therapy in patients undergoing major abdominal surgery.Methods Ninety-six patients undergoing major abdominal surgery were randomly assigned into transesophageal Doppler monitoring group (ODM group,n =49) and control group (C group,n =47).Fluid volume,urine volume,mean arterial pressure and heart rate,lactic acid and B-type natriuretic peptide at ICU admission and complications 7 days after surgery were compared between two groups.Results Fluid volume [(5651.5 ± 561.8) ml vs.(5423.8 ±542.3) ml,P ＜0.05],urine volume [(376.5 ±99.6) ml vs.(228.9 ±68.2) ml,P ＜0.01] in ODM group significantly increased as compared with control group.At the end of operation,mean arterial pressure [(80.3 ± 8.2) mum Hg (1 mm Hg =0.133 kPa) vs.(70.0 ± 5.1) mm Hg,P ＜ 0.01] was higher in ODM group than that in control group,but no significant difference was found in heart rate between groups (P ＞ 0.05).Lactic acid [(1.9 ± 0.3) mmol/L vs.(3.8 ± 1.1) mmol/L,P ＜ 0.01] at ICU admission was markedly lower in ODM group than that in control group,but BNP showed no significant difference between groups.At 7th day after surgery,incidence of complications was lower in ODM group than that in control group.Conclusion Fluid therapy was guided with ODM,which could improve tissue oxygenation and low complication after surgery. Key words: Transesophageal doppler monitoring; Major abdominal surgery; Fluid therapy; Stroke volume