Study the effect of changes in blood pressure and contractility of heart after intravascular fluid transfusion in prone position during spine surgery.

Completed

• Conditions: posted for lumbar fixation surgery

• Registration Number: CTRI/2018/03/012688
• Lead Sponsor: Bangur Institute of Neurosciences

Brief Summary

The aim of our study was to evaluate the ability of PPV and SVV to predict fluid responsiveness in mechanically ventilated patients in the prone position (PP) during lumbar fixation surgery.

For the study we enrolled sixty subjects who were studied after the induction of anaesthesia in the supine position [before and after volume expansion (VE) with 500 ml of hetastarch 6%] and in PP [immediately after PP and before and after (VE)]. PPV, SVV, cardiac output (CO), and mean arterial pressure(MAP) were recorded at each interval. Subjects were defined as responders (Rs) to VE if CO increased ≥15%.

Finding

We found that in the supine position, 42 subjects were Rs. Fluid responsiveness was predicted in supine position by PPV >11.6% (sensitivity=97.6%, specificity=94.44%) and by SVV >13% (sensitivity=80.95%, specificity=100%). PP induced an increase in PPV and SVV (*P*<0.0001). In PP, 34 patients were Rs. In PP PPV and SVV before VE were correlated with VE-induced changes in CO. Fluid responsiveness was predicted in PP by PPV >13% (sensitivity=97.06%, specificity=96.15%) and by SVV >14% (sensitivity=100%, specificity=100%).

Results

So, from our study we concluded that functional haemodynamic parameters like PPV and SVV are robust indicators of fluid responsiveness of patients.

Even though PP induces a significant increase in PPV and SVV but does not alter their abilities to predict fluid responsiveness.

Thus, PPV and SVV can be used as powerful parameters to predict fluid responsiveness of patients even in PP.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-01-04
• Study Completion: 2017-12-31
• Last Update Posted: 2018-03-19

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1)Adult patients between 20-65years 2)ASA 1&2 3)Patients of both sexes 4.Patients scheduled for elective lumbar fixation surgery in BIN OT.

Exclusion Criteria

1.Patient refusal 2.Age<20 years 3.Patients with arrhythmia 4.BMI>40 or <15kg/m2 5.LVEF<50% 6.Patients with history of lung diseases 7.ASA 3 & 4 8.Autonomic dysfunction 9.Peripheral vascular disease.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
evaluate the abilities of pulse pressure variation( PPV) and stroke volume variation (SVV) to predict fluid responsiveness in prone position	Two sets of measurements were performed in supine position(T1 and T2) and three in prone position(T3,T4 and T5).

Secondary Outcome Measures

Name	Time	Method
changes in systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, heart rate (HR) and cardiac output (CO)	same time points of primary outcome

Trial Locations

Locations (1)

Bangur institute of neurosciences; 🇮🇳 Kolkata, WEST BENGAL, India

Bangur institute of neurosciences

🇮🇳Kolkata, WEST BENGAL, India

Sudeshna Padhi

Principal investigator

9674492663

drsudeshnapadhi123@gmail.com