Effects of goal-directed fluid therapy during anesthesia on patients with acute lung injury undergoing pulmonary lobectomy

Objective To discuss the effects of goal-directed therapy (GDT) during anesthesia on patients with acute lung injury undergoing pulmonary lobectomy and provide theoretical foundation for fluid management in pulmonary lobectomy. Methods Eighty patients undergoing pulmonary lobectomy in Tangdu Hospital, Fourth Military Medical University from May 2013 to April 2014 were randomly divided into control group (group C, n=40) and goal-directed group (group G, n=40). Patients in group C received conventional fluid therapy with mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) measurement etc, while those in group G received GDT according to stroke volume variation (SVV) guided by Vigileo monitor. The parameters including HR, MAP, cardiac index (CI) and central venous oxygen saturation (ScvO2) were recorded. Clinical data about patients after operation, including pulmonary infection, pulmonary atelectasis, pulmonary edema and hospital stay, were recorded. Results There was no statistically significant difference in general information between two groups. No statistically significant differences in HR, MAP and CI were found. Fluid intake during operation and positive fluid balance during post-operation period were significantly lower in group G compared with group C (1 180±213) ml vs (1 950±426) ml, (421±189) ml vs (879±243) ml, P ＜ 0.05. The stay time in ICU of group G was shorter than group C, while the oxygen index of group G was higher than group C. The incidence of pulmonary complications such as acute lung injury was significantly lower in group G than group C. Conclusion GDT during anesthesia decreases the incidence of pulmonary complications such as acute lung injury after pulmonary lobectomy and improves clinical outcomes in patients undergoing pulmonary lobectomy.