The Effect of Norepinephrine on Cardiac Output in Patients Undergoing Liver Transplant .

Not Applicable

Completed

• Conditions: Liver Transplantation
• Interventions: Drug: Noradrenaline

• Registration Number: NCT04376281
• Lead Sponsor: Cairo University

Brief Summary

Early administration of NE in liver transplant recipient might enhance cardiac output through an increase in cardiac preload .

Detailed Description

The derangement of circulatory blood volume in patients with liver cirrhosis makes intraoperative fluid management during liver transplant is challenging . Cirrhotic patients not only have large blood volume but abnormal blood volume distribution, with a substantial fraction of this volume in the splanchnic circulation (. These hemodynamic changes render volume loading in these patients has little impact on CO because a large proportion of infused fluid is shifted to the splanchnic system . In addition, patients with liver cirrhosis is similar to septic patients who have increased total vascular compliance which may cause pooling of blood in venous pool. Several studies in patients with sepsis found that use of low dose vasopressor may convert unstressed blood volume (i.e the amount of blood not causing pressure on the vessels) to stressed volume (i.e additional blood causing a distending pressure on the vascular walls and reflects the effective circulating volume) . However, no previous studies tested the effect of using norepinephrine (NE) on venous return and cardiac preload in patients undergoing liver transplant. An obvious advantage of this possibility is that NE will be used instead of true fluid replacement which may minimize fluid replacement during operation.

Recently, a method was described to estimate the changes in intravascular volume and vascular capacitance by calculating mean systemic filling pressure (MSFP) . MSFP is the driving pressure in venous return, and it allows calculation of the arterial and venous components of systemic vascular resistance .

Study Timeline

• Study Start: 2019-12-15
• Study First Submitted: 2020-04-15
• Study First Submitted QC: 2020-05-04
• Study First Posted: 2020-05-06
• Primary Completion: 2021-08-01
• Study Completion: 2021-10-01
• Status Verified: 2021-11
• Last Update Submitted: 2021-11-08
• Last Update Posted: 2021-11-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 31

Inclusion Criteria

• All Adults (age > 18 years) patients undergoing living donor liver transplant (LDLT) will be considered for inclusion in the study..

Exclusion Criteria

• Patients less than 18 years.
• Patients undergoing liver transplantation for acute liver failure .
• All Chronic Hypertensive patients on medication , whether controlled on not controlled
• Those with high risk of post transplant renal dysfunction (serum creatinine >1.5 mg/dL at time of transplant)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Noradrenaline group	Noradrenaline	-

Primary Outcome Measures

Name	Time	Method
The effect of Noradrenaline on change of cardiac output .	along the procedure ; from skin incision to the end of surgery	The effect of Noradrenaline on change of cardiac output .

Secondary Outcome Measures

Name	Time	Method
The effect of NE on central venous pressure .	along the procedure ; from skin incision to the end of surgery	The effect of NE on central venous pressure .
The effect of NE on mean systemic filling pressure .	along the procedure ; from skin incision to the end of surgery	The effect of NE on mean systemic filling pressure .
The effect of NE on venous return .	along the procedure ; from skin incision to the end of surgery	The effect of NE on venous return .

Trial Locations

Locations (1)

kasr El Ainy school of medicine; 🇪🇬 Cairo, Egypt