Adequate and balanced fluid resuscitation is one of the cornerstones of intraoperative patient management. Over-resuscitation leading to positive fluid balance is associated with increased postoperative mortality and morbidity. Invasive and non-invasive technologies can be used for the adequacy of intraoperative fluid therapy. Lung ultrasonography (LUS) is a safe and accurate bedside imaging method. LUS, which is frequently used in the diagnosis of postoperative hypoxemia, has also begun to be preferred for fluid management in intensive care units.
In this study, we aimed to investigate the effectiveness of intraoperative LUS data in the control of fluid therapy.
Study Type
OBSERVATIONAL
Enrollment
50
Lung ultrasonography ; lung ultrasonography will be applied in 4 quadrants according to the LUS protocol and LUS score will be created.
LUS
Lung ultrasound score (LUS) Lung ultrasonography; Lung ultrasound score will be created by performing ultrasonography in 4 quadrants according to the previously defined protocol. 0 points indicated the presence of only A lines, less than 2 B lines 1. point indicated 1-2 B lines 2. points indicated the presence of more than 3 well-spaced B lines; 3. points indicated the presence of combined B lines
Time frame: peroperative
PVI
Pulse variable index (PVI) will be measured by finger pulse oximetry with the MASİMO device.
Time frame: peroperative
CVP
Central venous pressure(CVP) Pressure values measured by a central venous catheter applied by jugular or subclavian route
Time frame: peroperative
postoperative pulmonary complication
hypoxia (partial oxygen pressure below 95 on pulse oximetry and 10% decrease from the initial value) atelectasis
Time frame: postoperative 6th hour
biochemical data 1
glomerular filtration rate (GFR) values normal results range from 90 to 120 mL/min/1.73 m2.
Time frame: postoperative 6th hour
biochemical data 2
Blood urea nitrogen value mg/dl
Time frame: postoperative 6th hour
biochemical data 3
Blood creatinine value mmol/dl
Time frame: postoperative 6th hour
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Mechanical ventilation data 1
End-Tidal Carbon Dioxide Pressure mm/hg The partial pressure of CO2 detected at the end of exhalation is between 35 and 45 mm Hg or 4.0 to 5.7 kPa.
Time frame: peroperative
Mechanical ventilation data 2
Peak inspiratory pressure Values Peak inspiratory pressure is the highest pressure applied to the lungs during inhalation and should be kept below 35 cmH2O.It is automatically measured by respirators.
Time frame: peroperative
Mechanical ventilation data 3
Tidal Volume value Tidal volume is the volume of gas moving into and out of the lungs with each breath. Normal tidal volume is 6 to 8 mL/kg, regardless of age. It is automatically measured by respirators.
Time frame: peroperative