Dynamic Preload Dependence Indices in Laparoscopic Surgery

Dynamic Preload Dependence Indices in Laparoscopic Surgery

A goal-directed fluid management is definitely beneficial in high risk surgery. The fluid administration can be directed by cardiac output monitoring which evaluate the response to repeated fluid challenge or by preload dependence indices. These indices are not well validated in laparoscopic surgery while pneumoperitoneum can alter venous return or pulmonary compliance.

The aim of the study is to study the validity of pulse pressure variation to predict fluid response under laparoscopic conditions and to describe the effect of the pneumoperitoneum on the dynamic preload indicators, i.e. the pulse pressure variation, the plethysmographic waveform of pulse oximetry variation and the stroke volume variation.

Inclusion Criteria:

• Need to laparoscopic colectomy or hepatic resection
• Written informed consent

Exclusion Criteria:

• Cardiac arrhythmia
• Esophageal and cervical pathologies
• Radial artery Allen test negative
• Allergy to anesthesic treatment, to egg or soja
• Severe kidney failure (estimated glomerular filtration rate < 30 ml/min)
• Age < 18 years old
• Pregnancy