Continuous Cardiac Output Monitoring Using esCCO: a Validation vs. Transpulmonary Thermodilution in Off-pump Coronary Artery Bypass Grafting
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pulse Wave Analysis
- Sponsor
- Northern State Medical University
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Accuracy (between the method bias and angular bias) and precision (between the method standart deviation and radial limit of agreement) of esCCO cardiac output measurement
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The main goal of our study is to assess the accuracy and reproducibility of continuous beat-to-beat cardiac output (CO) measurement using pulse wave transit time in patients undergoing off-pump coronary artery bypass grafting.
Detailed Description
Using appropriate statistical methods the cardiac index values obtained via pulse wave transit time with esCCO system will be compared with traditional transpulmonary thermodilution technique.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Elective isolated off-pump coronary arteries bypass grafting.
- •Age \> 18 years and \< 80 yrs.
- •Preoperative echocardiographic ejection fraction \> 0.35
Exclusion Criteria
- •Simultaneous operation (carotid endarterectomy, ventricular aneurysm resection, etc.).
- •Constant form of atrial fibrillation.
- •Severe valve dysfunction.
- •Peripheral vascular disease (including significant peripheral arteriopathy" which precludes the use of peripheral plethysmography).
- •The surgical requirement to harvest both radial arteries.
- •Intraaortic balloon pump.
- •Discontinuation Criteria:
- •Transfer to cardiopulmonary bypass (on-pump CABG).
- •The PEEP test will be discontinued before standard duration in patients with PEEP-induced profound MAP decrease below 50 mm Hg, bradycardia (\< 50/min) or CIPCA \< 1.9 l/min/m2 exceeding 1 minute.
Outcomes
Primary Outcomes
Accuracy (between the method bias and angular bias) and precision (between the method standart deviation and radial limit of agreement) of esCCO cardiac output measurement
Time Frame: Up to 24 hrs post surgery
Mean bias and standard deviation according to Bland-Altman analysis and angular bias and radial limit of agreement according to polar plot analysis for cardiac output assessed using pulse wave transit time in comparison with transpulmonary thermodilution
Secondary Outcomes
- Ability of augmented PEEP test (changes in cardiac output in response to an increase in PEEP) for predict the fluid responsiveness (changes in cardiac output in response to fluid load) in the early postoperative period(Immediate postoperatively)
- Ability of mini fluid load test (changes in CO in response to fast injection of minimal fluid volume) to predict fluid responsiveness (changes in CO in response to injection of standard fluid volume) in the immediate postoperative period following OPCAB(Immediate postoperatively)