{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:21:34Z","timestamp":1760059294487,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Technology, Taiwan","award":["MOST 107-2314-B-002-071-MY2"],"award-info":[{"award-number":["MOST 107-2314-B-002-071-MY2"]}]},{"name":"Taiwan Respiratory Health Association","award":["MOST 107-2314-B-002-071-MY2"],"award-info":[{"award-number":["MOST 107-2314-B-002-071-MY2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The use of goal-directed fluid therapy (GDFT) guided by stroke volume (SV) variation during thoracic surgery, particularly with one-lung ventilation (OLV) and protective ventilation strategies, is not well established. This study aimed to determine whether maximizing stroke volume (SV) before initiating one-lung ventilation (OLV) reduces the incidence of intraoperative hypotension requiring vasoactive agents during video-assisted thoracoscopic surgery (VATS). Methods: Sixty patients undergoing VATS were randomly assigned to an SVM group (n = 30) or a control group (n = 30). The SVM group received 6% hydroxyethyl starch before OLV to achieve and maintain an SV increase of less than 10%. The control group received no active fluid therapy before OLV positioning. Both groups received Ringer\u2019s lactate solution intraoperatively based on baseline (control) or maximized (SVM) SV goals. The primary outcome was the use of vasoactive agents for hypotension. Results: Patients in the SVM group received significantly less Ringer\u2019s lactate solution than controls (4.2 \u00b1 2.4 vs. 6.1 \u00b1 2.8 mL\/kg\/h, p = 0.005). While fewer patients in the SVM group required vasoactive agents (20% vs. 40%), the difference was not statistically significant (p = 0.091). IL-6 levels were significantly lower during OLV in the SVM group. Conclusions: Pre-OLV SVM was associated with reduced intraoperative crystalloid administration and attenuation of inflammatory response, with a non-significant trend toward lower vasopressor use. These findings suggest a potential benefit of SVM in thoracic surgery, though larger multicenter trials are needed to confirm clinical efficacy.<\/jats:p>","DOI":"10.3390\/diagnostics15111405","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T03:19:38Z","timestamp":1748834378000},"page":"1405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Stroke Volume Maximization Before One-Lung Ventilation on Video-Assisted Thoracic Surgery: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7097-7189","authenticated-orcid":false,"given":"Man-Ling","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Ni","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsao-Hsun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan"},{"name":"Medical Services Department, National Taiwan University Cancer Center, Taipei 100200, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Shing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9150-4690","authenticated-orcid":false,"given":"Ya-Jung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jtcvs.2014.08.071","article-title":"Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections","volume":"149","author":"Arslantas","year":"2015","journal-title":"J. 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