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Prediction of Fluid Responsiveness in Children With Single Ventricle

Not Applicable
Completed
Conditions
Hypovolemia
Interventions
Procedure: abdominal compression
Registration Number
NCT02826135
Lead Sponsor
Seoul National University Hospital
Brief Summary

The purpose of this study is to evaluate predictability of an abdominal compression-induced change of blood pressure for fluid responsiveness in children with single ventricle (bidirectional cavopulmonary shunt and Fontan tract).

Detailed Description

The purpose of this study is to evaluate predictability of an abdominal compression-induced change of blood pressure for fluid responsiveness in children with single ventricle (bidirectional cavopulmonary shunt and Fontan tract).

When there are clinical signs of hypovolemia, such as hypotension, decreased urine output or decreased central venous pressure, right upper abdomen is gently compressed for 10 seconds. Changes of blood pressure are continuously recorded during this period. About 3 min later, intravenous colloid fluid 10 mL/kg is infused for 20 min.

To evaluate the change of cardiac output, transesophageal or transthoracic echocardiography is performed before and after fluid administration. In addition, hemodynamic parameters including pulse pressure variation, systolic pressure variation, pleth variability index and central venous pressure are also recorded before and after fluid administration.

Finally, patients will be divided into fluid responder group and non-responder group. If cardiac output measured using echocardiography increases over 15% after fluid administration, the patient is fluid responder. Using ROC curve, diagnostic power of abdominal compression-induced blood pressure change for fluid responsiveness will be evaluated

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Pediatric patients undergoing elective surgery, who require invasive blood pressure and central venous pressure monitoring during surgery
  • Patients with bidirectional cavopulmonary shunt or fontan tract
Exclusion Criteria
  • renal, hepatic and pulmonary disease
  • preoperative infection: increased CPR, WBC over 10,000, and with fever
  • genetic and hematologic disease
  • ventricular dysfunction
  • increased intracranial pressure

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Pediatric patients with hypovolemic stateabdominal compressionRight upper abdominal compression is performed in patients with hypovolemic signs including hypotension, decreased urine output or decreased central venous pressure. Changes of blood pressure during abdominal compression is continuously recorded.
Primary Outcome Measures
NameTimeMethod
Changes in stroke volume index after volume expansionbefore and after fluid administration (20 min)
Secondary Outcome Measures
NameTimeMethod
Changes in pleth variability index after volume expansionbefore and after fluid administration (20 min)
3.Changes in respiratory changes of peak aortic blood flow velocities after volume expansionbefore and after fluid administration (20 min)

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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