Fluid status after bowel preparation for colonoscopy: objective assessment and relationship to hypotension under sedatio

Not Applicable

Completed

• Conditions: endoscopy; dehydration; Anaesthesiology - Anaesthetics; Oral and Gastrointestinal - Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon

• Registration Number: ACTRN12616000614493
• Lead Sponsor: Megan Allen

Brief Summary

Patients who underwent elective lower intestinal endoscopy were commonly hypovolaemic on pre-procedure transthoracic echocardiography. The agreement between expert echocardiography reporters was moderate. The agreement of haemodynamic parameters between transthoracic echocardiography and the ClearSight non-invasive cardiac output monitor was poor. When patients were sedated for their endoscopy procedure, their blood pressure was very commonly lower than at baseline, and this reached a clinically important level for a significant minority of patients. Strategies to reduce dehydration and low blood pressure in patients undergoing sedation for endoscopy are important targets for future research.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2016-05-11
• Study Completion: 2019-03-28
• Last Update Posted: 20 November 2023

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 104

Inclusion Criteria

1.Electively booked endoscopy procedure
2.Adult patients undergoing endoscopy procedures where bowel preparation solution has been administered (colonoscopy, gastroscopy combined with colonoscopy with both diagnostic and therapeutic intent including polypectomy)
3.Language and cognitive ability to understand and comply with study requirements
4.No local injury or contraindication to the use of transthoracic echocardiography (TTE) imaging

Exclusion Criteria

1.Emergency procedures
2.Patients undergoing endoscopy without receiving, or not completing, bowel preparation solution
3.Patients with language or cognitive barriers to full understanding of the study procedures and the ability to obtain consent
4.Patients undergoing advanced endoscopic procedures (ERCP, enteroscopy, endoscopy via stoma, banding haemorrhoidectomy)
5.Contraindication to the use of transthoracic echocardiography

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The proportion of patients who are intravascularly deplete as assessed by a positive Passive Leg Raise (PLR) test on TTE (greater than or equal to 15% increase in the sub-aortic velocity time index) [ Assessment on the day of endoscopy prior to endoscopy commencement]

Secondary Outcome Measures

Name	Time	Method
The rate of hypotension (Systolic BP less than 90mmHg or 25% decrease from baseline) during endoscopy in patients who are intravascularly deplete (positive primary outcome) compared to those that have normal intravascular volume status. Blood pressure will be measured by automatic sphygnomanometer on a 2.5 minutely cycle. [ TTE performed immediately prior to endoscopy examination and blood pressure measured throughout the endoscopy procedure at 2.5 minute intervals. ];Intravascular volume depletion measured on echocardiography by assessment of inferior vena cava collapsibility [ On the day of endoscopy prior to examination commencement];Quality of recovery (assessed using the QoR-15) following endoscopy in patients who are intravascularly deplete compared to those with normal intravascular volume status prior to endoscopy[ At the time of hospital discharge following endoscopy]