Fluid Responsiveness Prediction Using Pulse Pressure Variation - Integrating Ventilator Settings
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 52
- 试验地点
- 1
- 主要终点
- >10% Increase in stroke volume from before to after a fluid bolus. (Fluid responsiveness)
研究概览
简要总结
It is well known, that patients with circulatory impairment sometimes, but not always, benefit from intravenous fluids. Predicting if a fluid administration will improve circulation is therefore of substantial clinical interest.
Ventilator treatment induces cyclic variation in blood pressure due to interaction between the lungs and the heart. This variation is minor, but its amplitude may be used for guiding fluid administration.
However, this method of using ventilator-induced variation in blood pressure to predict the effect of fluid administration was developed when different settings for ventilator treatment was recommended, compared with today. With today's recommend ventilator treatment, the method is, unfortunately, less reliable.
The investigators will investigate how different ventilator settings influence variation in blood pressure, and the investigators will test if this knowledge allows us to better predict the effect of a fluid administration, by taking the ventilator settings into account.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Scheduled open abdominal surgery.
- •Scheduled treatment with Aarhus University Hospital's goal-directed therapy protocol (hemodynamic monitoring).
排除标准
- •Left ventricular ejection fraction ≤ 40 %
- •Irregular heart rhythm (e.g. atrial fibrillation or frequent ectopic beats)
- •Known right ventricular dysfunction (if reported qualitatively in pre-operative assessment or objectively via Tricuspid Annular Plane Systolic Excursion (TAPSE) < 17 mm)
- •Pregnancy
- •Prior participation in this study
结局指标
主要结局
>10% Increase in stroke volume from before to after a fluid bolus. (Fluid responsiveness)
时间窗: From two minutes before to two minutes after a fluid administration.
A patient is considered a fluid responder if they have a \>10% increase in stroke volume (pulse contour analysis by the Edwards EV1000 with a FloTrac sensor). Pre-fluid stroke volume is calculated as the median stroke volume estimate in the two minutes immediately preceding the fluid bolus. Post-fluid stroke volume is calculated as the median stroke volume estimate in the two minutes immediately following the fluid bolus. Change in stroke volume is calculated as: 100% \* (Post-fluid stroke volume - Pre-fluid stroke volume) / Pre-fluid stroke volume
次要结局
未报告次要终点