Echo FLOW Versus (Non-)Invasive Haemodynamics
- Conditions
- Cardiac Output, HighCardiac Output, Low
- Interventions
- Diagnostic Test: carotid blood flow measurement with ultrasound
- Registration Number
- NCT04593797
- Brief Summary
Rationale: Diligent fluid management is instrumental to improve postoperative outcome, cost and quality of care.
Objective: To determine the accuracy of brachial, femoral and carotid blood flow measurement with ultrasound compared to intermittent transpulmonary thermodilution cardiac output measurement, invasive and non-invasive pulse-contour analysis.
Study design: Observational study - Prospective clinical non-intervention measurement study.
Study population: Adult ASA 1-2 patients, scheduled for open upper GI surgery Intervention (if applicable): Not applicable. We will perform non-invasive ultrasound measurements of the femoral, carotid and brachial blood flow right before induction and under anaesthesia.
Main study parameters/endpoints: Femoral, carotid and brachial blood flow determined by ultrasound and blood flow variation and the accuracy compared to transpulmonary thermodilution cardiac output, stroke volume variation, and pulse-contour analysis derived cardiac output (invasive or non-invasive) at the following time points during surgery; (limited for femoral site as it cannot be measured during surgery): (1) before induction of anaesthesia, (2) after induction, (3) 15 minutes after start of surgery, (4) before and (5) after (1-2 minutes) a fluid bolus, (6) before and (7) after start of vasopressors, (8) before and (9) after Trendelenburg position and (10) after surgery before end of anaesthesia (figure 1). A fluid bolus will be performed as part of standard care (goal-directed fluid therapy). The vasopressor and Trendelenburg position time points are optional measurements. We will also measure (continuous) invasive femoral blood pressure (SBP, DBP, MAP), non-invasive blood pressure, SVV, central venous pressure (when available), heart rate, SpO2, PFI, etCO2.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 20
- Elective open GI surgery
- Invasive arterial blood pressure monitoring
- Informed consent
- Significant stenosis > 30% or abnormal anatomy of aortic, femoral, carotid or brachial artery
- Cerebrovascular accident
- Atrial fibrillation
- COPD stage 3-4
- Lobectomy / pneumectomy
- Active pneumonia
- Cardiac failure
- Severe heart valve regurgitation or stenosis
- Not able to measure brachial or carotid artery blood flow during surgery
- Contra-indications for femoral arterial catheter placement (e.g., vascular graft)
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Patients undergoing major upper abdominal surgery carotid blood flow measurement with ultrasound major open upper abdominal surgery eg pancreatic, liver surgery
- Primary Outcome Measures
Name Time Method Cardiac output baseline blood flow determined by ultrasound and the accuracy compared to transpulmonary thermodilution calibrated continuous cardiac output
- Secondary Outcome Measures
Name Time Method Cardiac output change change from baseline cardiac output 1 minute after intervention (fluid challenge, vasopressor administration, or Trendelenburg) Change in blood flow compared to change in cardiac output
Trial Locations
- Locations (1)
Academisch Medisch Centrum - Universiteit van Amsterdam
🇳🇱Amsterdam, Netherlands