Application of PiCCO in the evaluation of hemodynamics in elderly patients with fracture undergoing surgery with general anesthesia

Objective To analyze the use of pulse-indicated continuous cardiac output (PiCCO) in monitoring the hemodynamics of elderly patients with fracture undergoing surgery with general anesthesia. Methods A total of 60 elderly patients with fracture who underwent surgery were selected. According to the random number table method, they were divided into two groups (n=30): a control group and an observation group. All the patients underwent hemi-arthroplasty or total hip arthroplasty. Patients in the control group were monitored by a conventional hemodynamic detector, while those in the observation group received PiCCO monitoring. Both groups were compared for their hemodynamic changes before anesthesia induction (T0), before skin incision (T1), when the joint capsule was opened (T2) and closed (T3). Results There was statistical difference in heart rate (HR) between the two groups at T1 to T3 (P<0.05); in central venous pressure (CVP) and stroke volume variation (SVV) between the two groups at T2 and T3 (P<0.05); and in mean arterial pressure (MAP) between the two groups at T3 (P<0.05). Compared with those at T0, the observation group showed decreases in cardiac index (CI), pulmonary vascular permeability index (PVPI), extravascular lung water index (ELWI), and intrathoracic blood volume index (ITBI) at T1; these indicators increased at T2 and basically returned to normal at T3; no statistical difference was found in each time points in all the indicators except ITBI within the group except (P>0.05). Furthermore, the observation group presented remarkably decreased intraoperative fluid infusion volume and urine volume, as well as shortened first exhaust time, defecation time and normal eating time, compared with the control group (P<0.05). Conclusions The use of PiCCO in monitoring elderly patients with fracture who undergo surgery with general anesthesia can accurately reflect the hemodynamics of patients, guide rational fluid management during surgery, improve the quality of anesthesia, and enhance the surgical effects, and play a positive role in accelerating the recovery of gastrointestinal function after surgery.