Stroke Volume Variation vs Central Venous Pressure Guidance Fluid Management in Endovascular Aortic Repair

Objective: To compare postoperative clinical outcome in adult patient undergoing EVAR.

Primary outcome: Postoperative serum lactate and creatinine.

Secondary outcome: Postoperative complications.

Methods: Eligible patients will be randomized to 2 groups. Both groups will be managed intraoperatively in the same way, except fluid management protocol. SVV group will be managed according to stroke volume variation (SVV) protocol, i.e., control SVV 10-13% and give fluid when SVV > 13%. CVP group will be managed using central venous pressure (CVP) protocol, i.e., control CVP 8-12 mmHg and give fluid when CVP < 8 mmHg.

Outcome analyses: Postoperative serum lactate and creatinine of both groups will be compared using unpaired Student-t test. Secondary outcomes will be compared using chi-square test.

Inclusion criteria

• 40-80 years old
• Patient had aortic aneurysm both thoracic and abdominal types
• Scheduled for elective EVAR procedures
• New York Heart Association (NYHA) or American society of Anesthesiology (ASA) classification I-III
• Body mass index (BMI) 18-24 kg/m2
• Provided informed consent before surgery

Exclusion criteria

• Scheduled for emergency or redo surgery
• Received prior fluid therapy (>2,500 ml/day over the 48 h before the surgery)
• Presence of congenital heart disease, cardiomyopathy, rheumatic heart disease, or significant arrhythmia or cardiopulmonary dysfunction, or significant renal or liver diseases
• Preoperative use of vasoactive drugs (e.g. digoxin, nitroglycerine, nifedipine) for ≥3 months
• Difficulty (or contraindication to) placing a central venous catheter
• Inability to cooperate (e.g. mental disorder, disturbance of consciousness, mental retardation)
• Presence of blood-borne infectious disease (e.g. syphilis, acquired immunodeficiency