Anesth Pain Med.  2019 Jul;14(3):316-321. 10.17085/apm.2019.14.3.316.

The change of stroke volume variation during thoracotomy or one lung ventilation

• Lim H
• Kim DC
• Kim MJ
• Yoo S
• Ki MJ
• Kang S
• Kim D

• KMID: 2454817
• DOI: http://doi.org/10.17085/apm.2019.14.3.316

Abstract

BACKGROUND
Stroke volume variation (SVV) is based on cyclic changes of intrathoracic pressure during respiratory cycle. Thoracotomy and one-lung ventilation (OLV) can lead to changes in airway and intrathoracic pressure. The aim of this study was to determine whether thoracotomy and converting from two lung ventilation to OLV could affect SVV values.
METHODS
Thirty patients who were scheduled for pulmonary lobectomy or pneumonectomy requiring OLV were enrolled. Induction and maintenance of anesthesia were performed with propofol and remifentanil via total intravenous anesthesia. Hemodynamic variables including mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), and SVV were measured at intervals of 1 min for 10 min after thoracotomy and OLV, respectively.
RESULTS
MAP and HR increased from baseline at intervals between 3 and 10 min and between 4 and 10 min after thoracotomy, respectively (P < 0.001). CI increased between 4 and 10 min (P < 0.001). SVV did not change for 10 min after thoracotomy. After OLV, MAP decreased between 4 and 10 min (P = 0.112). SVV was the highest at 1 min after OLV. It returned to the baseline value at 7 min (P < 0.001). CI decreased between 8 and 10 min after OLV (P < 0.001).
CONCLUSIONS
SVV can increase after OLV temporarily. Transient increase of SVV may be considered when fluid responsiveness is predicted by SVV during early period after OLV.

Keyword

One lung ventilation; Stroke volume; Thoracotomy

MeSH Terms

Anesthesia
Anesthesia, Intravenous
Arterial Pressure
Heart Rate
Hemodynamics
Humans
Lung
One-Lung Ventilation*
Pneumonectomy
Propofol
Stroke Volume*
Stroke*
Thoracotomy*
Ventilation
Propofol

Figure

• 

  Fig. 1 Change of hemodynamics after thoracotomy. Mean arterial pressure (MAP) and heart rate (HR) increased at 3–10 and 4–10 min, respectively (P < 0.001). Cardiac index (CI) increased at 4–10 min (P < 0.001). Stroke volume variation (SVV) was not changed for 10 min (P = 0.084). Values are presented as medians (1Q, 3Q). *P < 0.05 vs. baseline value.

• 

  Fig. 2 Change of hemodynamics after one lung ventilation. Mean arterial pressure (MAP) decreased at 4–10 min (P < 0.001) while heart rate (HR) did not changed (P = 0.112). Stroke volume variation (SVV) increased to the highest at 1 min and returned to the baseline value at 7 min. Cardiac index (CI) decreased at 8–10 min (P < 0.001). Values are medians (1Q, 3Q). *P < 0.05 vs. baseline value.

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