Anemia on Sublingual Microcirculation in GDFT

Effects of Anemia on Sublingual Microcirculation in Patients Undergoing Goal-Directed Fluid Therapy: A Prospective Observational Study

The goal of this observational study is to learn about the effects of anemia on sublingual microcirculation in patients undergoing goal-directed fluid therapy (GDFT) during surgery. The main question it aims to answer is:

Does anemia, under the condition of goal-directed fluid therapy, lead to significant changes in sublingual microcirculatory parameters (such as microvascular density and perfusion)?

Participants will include 54 patients scheduled for elective open radical gastrectomy (27 anemic vs. 27 non-anemic). Sublingual microcirculation will be assessed using a side-stream dark field imaging device at four time points: before anesthesia induction (T0), after induction (T1), after specimen removal (T2), and after anastomosis completion (T3). All patients will receive intraoperative GDFT guided by pulse pressure variation (PPV) and cardiac output (CO) via the Vigileo-FloTrac system.

Inclusion Criteria:

• Scheduled for elective open radical gastrectomy
• Age ≥ 18 years
• ASA physical status I-III
• Undergoing general anesthesia with endotracheal intubation

Exclusion Criteria:

• Untreated ischemic heart disease or severe cardiovascular disease
• Acute or chronic respiratory failure, severe asthma, pulmonary bullae, pneumothorax, emphysema, bronchopleural fistula
• Oral or tongue disorders
• Scheduled for laparoscopic surgery
• Inability to position or observe the patient's head during surgery
• Refusal to participate after entering the operating room
• Intraoperative life-threatening events
• Hemodynamic instability during surgery