Effects of Preoperative Fluid Therapy on Microcirculatory Reactivity in Patients With MIDCAB After General Anesthesia
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Enrollment
- 126
- Primary Endpoint
- Change in DesStO2 is assessed
Study Overview
Brief Summary
Through preoperative fluid therapy, to investigate whether it can alleviate the microcirculation dysfunction after induction of anesthesia, and reduce the incidence of perioperative fluid therapy-related complications, thereby accelerating rehabilitation.
Detailed Description
Patients undergoing minimally invasive coronary artery bypass graft surgery were randomly divided into crystal group, colloid group and control group. The preoperative fluid reactivity was evaluated according to the passive leg lifting test (PLR). When stroke volume increased (△SV)>16%, the patients in the crystal (carbonate Ringer solution) and the colloid group (hydroxyethyl starch solution) were treated with volume therapy, while the control group was not treated with PLR test and volume therapy. Vascular occlusion test was used to observe the effect of anesthesia induction on tissue oxygen saturation recovery slope (RecStO2) after volume therapy, Goal-directed fluid therapy was used during operation, and the postoperative microcirculation function and the incidence of related complications were observed.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Triple (Participant, Care Provider, Investigator)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥ 18 years old
- •Plan to undergo elective minimally invasive coronary artery bypass grafting (left anterior descending branch);
- •Sign informed consent
Exclusion Criteria
- •Left ventricular ejection fraction <40%
- •Renal insufficiency (serum creatinine>177umol/L)
- •Liver insufficiency (AST, ALT>3 times)
- •Peripheral vascular disease
- •Carotid artery stenosis (>60%) VOT test contraindications (arm deformity, burns, arteriovenous shunt)
- •Use glucocorticoids, vasoactive drugs, inotropic drugs or intra-aortic balloon counterpulsation (IABP)
- •Allergic to colloidal fluids
Outcomes
Primary Outcomes
Change in DesStO2 is assessed
Time Frame: The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
DesStO2(%/min):The downhill slope of StO2 reflects the oxygen consumption rate
Change in tM is assessed
Time Frame: The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
The time for minimum value of StO2 to recover to maximum value of StO2
Secondary Outcomes
- Change in heart rate is assessed(4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation)
- Change in HS is assessed(4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation)
- Duration of stay in the intensive care unit(up to 60 days)
- Change in SDC-1 is assessed(4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation)
- Change in mean arterial pressure is assessed(4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation)
- Length of hospital stay(up to 60 days)
Investigators
Boqun Cui
Deputy chief physician
Beijing Anzhen Hospital