Background/aim: The percentage change in the stroke volume index (SVI) due to the mini fluid challenge (MFC) (MFC-?SVI%) is used commonly in daily practice. However, up to 20% of patients remain in the gray zone of this variable. Thus, it was aimed to compare the MFC-?SVI% and the percentage change in the cardiac power index (CPI) due to the MFC (MFC-?CPI%) with the baseline values of the pulse pressure variation (PPV) and stroke volume variation (SVV) in terms of their abilities to predict fluid responsiveness. Materials and methods: The SVI, CPI, SVV, and PPV were recorded before 100 mL of isotonic saline was infused (MFC), after MFC was completed, and after an additional 400 mL of isotonic saline was infused to complete 500 mL of fluid loading (FL). Patients whose SVI increased more than 15% after the FL were defined as fluid responders. Results: Sixty-seven patients completed the study and 35 (52%) of them were responders.The areas under the receiver operating characteristics curves for the MFC-?SVI% and MFC-?CPI% (0.94; 95% CI: 0.86?0.99 and 0.89; 95% CI: 0.79?0.95, respectively) were significantly higher than those for the SVV and PPV (0.63; 95% CI: 0.50?0.75 and 0.55; 95% CI: 0.42?0.67, respectively) (p < 0.001 for all of the comparisons). The gray zone analysis revealed that the MFC-?SVI% values of 12 patients were in the gray zone. Of the 12, the MFC-?CPI% values of 7 patients were outside of the gray zone. Conclusion: Fluid responsiveness can be predicted more accurately using the MFC-?SVI% and MFC-?CPI% than using the SVV and PPV. Additionally, concomitant use of the MFC-?SVI% and MFC-?CPI% is recommended, as this approach diminishes the number of patients in the gray zone.

Background/Objectives: Perioperative organ injury (POI) is frequently observed following hepatectomy as acute kidney injury (AKI), perioperative myocardial injury (PMI), or both. We aimed to determine the incidences of POI, PMI, and AKI, reveal the risk factors and predictive tools for POI occurrence, and evaluate the relationship between POI and patient outcomes. Methods: This was a single-center historical cohort study of consecutive patients. The primary endpoint was the occurrence of POI within 3 days following hepatectomy. Results: Out of 128 patients, POI, PMI, and AKI occurred in 48 (37.5%), 36 (28.1%), and 23 (18%) patients, respectively. Ten (7.8%) patients suffered from both PMI and AKI. The presence of chronic kidney disease or systolic/valvular heart disease, fluid balance more than 365 mL/h, and intraoperative bleeding more than 950 mL were the risk factors for POI. A tool created by using the intraoperative decline of central venous oxygen saturation and lactate value during skin closure performed well in predicting POI (area under the ROC curve: 0.79, p < 0.001). In patients with POI, the number of those who needed intensive care unit (ICU) follow-up for more than 1 day was significantly higher (21% vs. 6%, p: 0.01). The length of hospital stay for these patients was significantly longer as well (11 (8–18) vs. 9 (7–13) days, p: 0.02). Two patients (20% of 10 patients who suffered from both AKI and PMI) died in the 90-day follow-up. Conclusions: POI is a common complication following hepatectomy and is associated with longer hospital and ICU stays. Patients who suffer from both AKI and PMI have a higher risk of mortality.