Objective To explore the efficiency of carotid artery corrected blood flow time (FTc) in evaluating the volume responsiveness of patients undergoing laparoscopic colorectal surgery.
Methods Sixty patients undergoing laparoscopic colorectal surgery from February to May 2021,32 males and 28 females, aged 45-70 years, BMI 20-24 kg/m2, ASA physical status Ⅰ or Ⅱ were enrolled. Rehydration test was performed 5 minutes after tracheal intubation and after intestinal anastomosis was completed, and 6 ml/kg of 6% hydroxyethyl starch was infused within 15 minutes. Positive volume response was determined by a 15% increase in the stroke volume index (SVI). After first and second rehydration tests, the positive group was marked as R1 and R2, and the negative group was marked as NR1 and NR2. Immediately before the first rehydration test, 5 minutes after the first rehydration test, immediately before CO2 pneumoperitoneum, 5 minutes after CO2 pneumoperitoneum, immediately before the second rehydration test, and 5 minutes after the second rehydration test, SVI and FTc were recorded. Receiver operating characteristic (ROC) curves were used to analyze the power of FTc to assess volume responsiveness.
Results After the rehydration tests, the FTc of the R1 and the R2 were significantly increased (P < 0.05). Before CO2 pneumoperitoneum, the area under the FTc curves was 0.755 (95% CI 0.522-0.909, P < 0.05), and cut-off values of FTc was 325 ms, sensitivity 66.67%, specificity 77.78%. After CO2 pneumoperitoneum, the area under the FTc curves was 0.773 (95% CI 0.605-0.940, P < 0.05), and the cut-off values of FTc was 361 ms (sensitivity 100%, specificity 87.69%).
Conclusion FTc can be used to evaluate the volume response of patients undergoing laparoscopic colorectal surgery, and FTc has higher sensitivity and specificity in evaluating the volume response in CO2 pneumoperitoneum. |
