Usefulness of Stroke Volume Index Obtained with the FloTrac/Vigileo System for the Prediction of Acute Kidney Injury After Radical Esophagectomy

作者：Sugasawa Yusuke^*; Hayashida Masakazu; Yamaguchi Keisuke; Kajiyama Yoshiaki; Inada Eiichi

来源：Annals of Surgical Oncology, 2013, 20(12): 3992-3998.

DOI：10.1245/s10434-013-3084-5

To assess the impact of stroke volume index (SVI) at the end of esophagectomy upon postoperative renal function. %26lt;br%26gt;We reviewed medical records of 128 patients undergoing esophagectomy. Intraoperative hemodynamics were monitored with the FloTrac sensor/Vigileo monitor system in addition to standard monitors. Patients were divided into two groups according to SVI at the end of surgery: the normal SVI group (n = 76), with SVI a parts per thousand yen 35 ml/m(2), and the low SVI group (n = 52), with SVI %26lt; 35 ml/m(2). We compared postoperative renal function, indicated by serum creatinine and estimated glomerular filtration rate, on postoperative days 0 through 3. We also compared numbers of patients who developed postoperative acute kidney injury (AKI). %26lt;br%26gt;Although there were no intergroup differences in preoperative renal function or other intraoperative hemodynamic variables, including arterial pressure, central venous pressure, stroke volume variation, a volume of infusion, urine output, and the total intraoperative in-out balance, estimated glomerular filtration rate was significantly lower and serum creatinine was significantly higher in the low SVI group than in the normal SVI group on postoperative days 1 and 2 (P %26lt; 0.05). In addition, more patients developed postoperative AKI in the low SVI group than in the normal SVI group (12 of 52 vs. 5 of 76, P = 0.015). %26lt;br%26gt;Low SVI at the end of esophagectomy may represent a risk factor for AKI in the early postoperative period. Further studies are required to examine whether maintaining SVI above 35 ml/m(2) reduces the incidence of AKI after esophagectomy.

• 出版日期2013-11