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The Influence of Perioperative Optimisation to the Hip Arthroplasty Outcomes

Not Applicable
Completed
Conditions
Hip Osteoarthritis
Interventions
Procedure: Semi-closed loop infusion system tactic.
Procedure: Routine infusion therapy tactic
Registration Number
NCT03260309
Lead Sponsor
Vilnius University
Brief Summary

Success of the hip arthroplasty depends on the measures that optimize perioperative conditions.It is planned to evaluate semi-closed loop system in the hip arthroplasty surgery.

Detailed Description

Success of the total hip arthroplasty depends on the measures that optimize perioperative conditions. They increase the emotional stress of the staff and error probability. It is planned to evaluate semi-closed loop infusion system, its adaption for infusion application's influence to near and far treatment outcomes done by prospective randomized clinical trial. This is done by performing total hip arthroplasty. It's expected to evaluate the semi-closed loop system's influence on the doctor's emotional tension during the decision making.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients with osteoarthritis of the hip undergoing hip arthroplasty with spinal - epidural anesthesia
  • Age >50 and <85 years
  • ASA (American Society of Anesthesiology Classification) II physical status
  • Start of operation no later than 09:00
  • Signed informed consent form
Exclusion Criteria
  • Age <50 and >85 yers
  • BMI (Body Mass Index) <20 and >40 kg/m2
  • ASA I and ASA>II physical status
  • History of a bleeding disorder
  • Anemia before surgery Hb<110 g/l
  • Intravascular fluid infusion within 24 hours before study
  • Diabetes mellitus
  • Previous open hip surgery
  • Psychiatric illness (intake of other psychiatric medication than selective serotonin reuptake inhibitors)
  • Alcohol intake 5 U daily
  • Contraindication to spinal - epidural anesthesia
  • Surgery not by project surgeon
  • Start of operation later than 09:00
  • Atrial fibrillation
  • Narcotic addiction
  • History of DVT (Deep Vein Thrombosis), thromboembolic complications, acute cardiac insufficiency
  • Participation in the other study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
semi-closed system groupSemi-closed loop infusion system tactic.Semi-closed loop infusion system tactic. Programmed iv fluid and blood infusion system ,,Belmont Rapid Infuser" and programmable syringe pump for adrenaline infusion.
control groupRoutine infusion therapy tacticRoutine infusion therapy tactic
Primary Outcome Measures
NameTimeMethod
The efficiency of semi-closed loop infusion systemBefore the surgery and 12 hrs postoperatively

Determine the ratio of doctor's approved and rejected computer suggestions

Secondary Outcome Measures
NameTimeMethod
Perioperative blood lossBefore (baseline) the surgery,during surgery and 24hrs postoperatively

Non-invasive measurement of Hb (Masimo technology). Laboratory hemoglobin determination, evaluation of the bleeding volume

Coagulation activityBefore (baseline) the surgery and 24hrs postoperatively

Coagulation activity is investigated thromboelastically

ComplicationsWithin 6 days postoperatively

Registration of all complications

Wound healingWithin 6 days postoperatively

Evaluation of wound tissue condition, measurement of drainage fluid volume

Dosage physical exercise sampleWithin 6 days postoperatively

Timed up and go test

Infused fluid and red blood cell volumeBefore the surgery and 24hrs postoperatively

Repeated rehydration bolus (sol.Ringeri 2,5ml/kg), supportive fluid infusion (sol.NaCl 0,9% 1,5 ml/kg/hrs); evaluation of signs of anemia intolerance if Hb \< 110 g/l

Haemodynamic stabilityBefore (baseline) the surgery and 12 hrs postoperatively

Invasive measurement of arterial blood pressure

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