# Impact of goal-directed fluid therapy on serum cytokines (IL-2, IFN-g, TNF-a, IL-6, IL-8, and IL-10) in elderly patients undergoing thoracotomy

## TL;DR

This study found that goal-directed fluid therapy in elderly patients undergoing thoracotomy improves recovery and reduces inflammation compared to conventional methods.

## Contribution

The study is the first to investigate the impact of goal-directed fluid therapy on TH1 and TH2 cytokine levels in elderly thoracotomy patients.

## Key findings

- Goal-directed fluid therapy reduced postoperative recovery times and fluid intake compared to conventional therapy.
- Goal-directed therapy improved hemodynamic stability and reduced inflammatory cytokine levels.
- TH1 and TH2 cytokine levels were significantly altered post-surgery, indicating a modulated immune response.

## Abstract

This research aimed to investigate the effect of different fluid therapy approaches (conventional and goal-directed fluid management) on TH1 and TH 2 cytokines (IL-2, IFN-g, TN F-a, IL-6, and IL-8, IL-10) during the perioperative period of thoracotomy in elderly patients; as previous studies have only focused on surgical outcomes of goal-directed fluid management.

Sixty elderly patients who underwent thoracotomy from January 2022 to April 2024 were divided into the control group (CG) and the observation group (OG), with 30 cases in each group. The CG received routine fluid management, while the OG received goal-directed fluid management. The postoperative recovery status, fluid intake and output, hemodynamic indexes, and TH1 and TH 2 cytokine levels were compared between both groups.

The postoperative extubation time, drainage time, ICU stay and hospitalisation time in the OG were reduced than those in the CG (P<0.05). The urine volume, crystalloid volume, colloid volume and total fluid volume in the OG were reduced than in the CG (P<0.05). At 1 h after surgery (T2), the HR and MAP levels of the two groups were reduced than those before surgery (T1) (P<0.05); at the end of surgery (T3), the HR and MAP of the CG were raised than those at T1 (P<0.05); at T2, the HR and MAP levels in the OG were raised than those in the CG (P<0.05); at T3, the HR and MAP levels in the OG were reduced than those in the CG (P<0.05). 1 day after operation, the levels of IL-2, IFN-g, TN F-a, IL-6, and IL-8 were raised than those before surgery, (P< 0.05), and the levels of IL-10 was reduced than those before treatment (P<0.05).

Perioperative goal-directed fluid therapy for elderly patients with thoracotomy is beneficial to maintaining perioperative hemodynamic stability, improving serum levels of TH1 and TH 2 cytokines, reducing the body's inflammatory response, and facilitating early postoperative recovery. This was a novel finding that needs further investigation.