Comparison of Two Different Preload Targets of Stroke Volume Variation During Kidney Transplantation
- Conditions
- Kidney Transplant; ComplicationsRenal Failure Chronic
- Interventions
- Other: Crystalloid fluid administration with the target of stroke volume variation ≤ 6%Other: Crystalloid fluid administration with the target of stroke volume variation ≤ 12%
- Registration Number
- NCT03949036
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
The investigators sought to compare the effect of two preload targets of stroke volume variation of ≤6% and ≤12% on the postoperative renal function in patients undergoing living donor kidney transplantation. Goal-directed fluid therapy will be performed in both groups to maintain adequate stroke volume, stroke volume variation, mean arterial pressure (or systemic vascular resistance) during kidney transplantation. Only the preload target for giving crystalloid during surgery will be different between groups.
- Detailed Description
The adequate preload target of fluid management has not yet been established during kidney transplantation. Traditionally, sufficient intravascular volume status has been recommended to maintain perfusion to renal graft. Stroke volume variation was reported to be superior to the traditional target of central venous pressure. In this regard, the investigators sought to compare the effect of two preload targets of stroke volume variation of ≤6% and ≤12% on the postoperative renal function in patients undergoing living donor kidney transplantation. Goal-directed fluid therapy will be performed in both groups to maintain adequate stroke volume, stroke volume variation, mean arterial pressure (or systemic vascular resistance) during kidney transplantation. Only the preload target for giving crystalloid during surgery will be different between groups.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- Adults patients who are undergoing living donor kidney transplantation with continuous radial artery pressure monitoring
- Patients who have cardiac arrhythmia of atrial fibrillation, multiple ventricular premature complex
- Cardiac systolic dysfunction with left ventricle ejection fraction <50%
- Continuous arterial pressure monitoring at the site other than radial artery.
- Patients who are considered to be intolerant to rapid fluid administration
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description target of Stroke Volume Variation ≤ 6% Crystalloid fluid administration with the target of stroke volume variation ≤ 6% The rate of intraoperative fluid administration will be adjusted to achieve the target of Stroke Volume Variation ≤ 6%. A crystalloid bolus of 200 ml will be repeatedly administered every 20 min until the target was achieved. The basal rate of fluid administration will be 3 ml/kg/hr. target of Stroke Volume Variation ≤ 12% Crystalloid fluid administration with the target of stroke volume variation ≤ 12% The rate of intraoperative fluid administration will be adjusted to achieve the target of Stroke Volume Variation ≤ 12%. A crystalloid bolus of 200 ml will be repeatedly administered every 20 min until the target was achieved. The basal rate of fluid administration will be 3 ml/kg/hr.
- Primary Outcome Measures
Name Time Method serum neutrophil-gelatinase-associated lipocalin (NGAL) at the end of surgery urine biomarker of renal injury
- Secondary Outcome Measures
Name Time Method Delayed graft function determined by the incidence of hemodialysis during the first postoperative week Delayed graft function determined by the incidence of hemodialysis
Immediate graft function after eight days after surgery serum creatinine decrease less than 70% of preoperative value
serum neutrophil-gelatinase-associated lipocalin (NGAL) at the anesthesia induction procedure urine biomarker of renal injury
Delayed graft function determined by glomerular filtration rate during the 24 hours after surgery Delayed graft function determined by glomerular filtration rate (less than 10 ml/min/m2)
Delayed graft function determined by urine output (less than 1200 ml) during the first postoperative day Delayed graft function determined by urine output (less than 1200 ml)
Delayed graft function determined by serum creatinine during the 48 hours after surgery Delayed graft function determined by serum creatinine (No decrease in creatinine of more than 10% of preoperative value)
Incidence of postoperative bleeding during the first postoperative week Incidence of postoperative bleeding
hospital length of stay the first postoperative month hospital length of stay
Delayed graft function determined by serum creatinine (more than 2.5 mg/dL) during the 10 days after surgery Delayed graft function determined by serum creatinine (more than 2.5 mg/dL)
slow graft function after eight days after surgery serum creatinine decrease greater than 70% of preoperative value
Incidence of pneumonia during the first postoperative week Incidence of pneumonia
Delayed graft function determined by serum creatinine (do not decrease less than preoperative value) during the first postoperative week Delayed graft function determined by serum creatinine (do not decrease less than preoperative value)
serum creatinine value seventh postoperative day serum creatinine value
Incidence of wound infection during the first postoperative week Incidence of wound infection
Trial Locations
- Locations (1)
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of