Positive End-expiratory Pressure-induced Increase in Central Venous Pressure as a Predictor of Fluid Responsiveness in Robot-assisted Laparoscopic Surgery
- Conditions
- Prostatic NeoplasmUrinary Bladder Neoplasm
- Interventions
- Procedure: Fluid loading of volulyte 300 ml
- Registration Number
- NCT02977143
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. The authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
- Detailed Description
In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. As a preload index, the predictability of central venous pressure, pulse pressure variation and stroke volume variations may be impaired due to the impaired hemodynamics that result from the effect of increased abdominal pressure and decreased venous return. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. Therefore, the authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 50
- Adult patient undergoing robot-assisted laparoscopic radical prostatectomy or cystectomy.
- American Society of Anesthesiologist Physical Status Classification of 1, 2 or 3.
- Medical history of arrhythmia or new-onset arrhythmia after anesthesia induction.
- Valvular or ischemic heart disease or left ventricular ejection fraction less than 40%.
- Any significant pulmonary disease or history of chronic obstructive pulmonary disease
- End-stage renal disease or preoperative creatinine > 1.4 mg/dl
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Fluid responsiveness test Fluid loading of volulyte 300 ml First, apply 10 cmH2O positive endexpiratory pressure (PEEP) and measure the increase in central venous pressure (CVP) as well as other preload indexes (central venous pressure, mean arterial pressure, stroke volume variation). Second, measure the increase in cardiac index after administration of volulyte 300 ml. If cardiac index increase more than 10%, fluid responsiveness is confirmed.
- Primary Outcome Measures
Name Time Method fluid responsiveness 5 minutes after administration of 300 ml volulyte fluid responsiveness is determined when increase in cardiac index is more than 10%
- Secondary Outcome Measures
Name Time Method arterial carbon dioxide partial pressure (mmHg) 1 minutes after the start of skin closure arterial blood gas analysis
central venous pressure T4: 5 minutes after administration of volulyte 300 ml measurement of central venous pressure after fluid administration
cardiac index T4: 5 minutes after administration of volulyte 300 ml measurement of cardiac index after fluid administration
stroke volume variation T4: 5 minutes after administration of volulyte 300 ml measurement of stroke volume variation after fluid administration
abdominal pressure T4: 5 minutes after administration of volulyte 300 ml measurement of abdominal pressure after fluid administration
arterial oxygen partial pressure (mmHg) 1 minutes after the start of skin closure arterial blood gas analysis
Trial Locations
- Locations (1)
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of