The Validity of Combined End-expiratory and End-inspiratory Occlusion Test and Tidal Volume Challenge Test for Prediction of Fluid Responsiveness in Immediate Post-cardiac Surgery Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- The number of volume responder participants could be detected using each fluid responsiveness test
研究概览
简要总结
the study aims to examine the validity of combined end-expiratory and end-inspiratory occlusion test and tidal volume challenge test for prediction of fluid responsiveness in immediate post-cardiac surgery patients
详细描述
multiple studies prove that dynamic variables based on heart-lung interactions accurately can predict fluid responsiveness in mechanically ventilated patients, including pulse pressure variation (PPV) and stroke volume (SV) variation.
Furthermore, passive leg raising (PLR), end-expiratory occlusion test, and tidal volume challenge test, "Mini"-fluid challenge are currently available to assess fluid responsiveness.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients on mechanical ventilation
- •Patients ≥18 years of age
- •patients undergoing cardiac surgery (coronary artery bypass graft, valve repair/ replacement, combined cardiac surgery)
- •patients with normal systolic function of the left and right ventricle
- •patient is mechanically ventilated with a protective lung strategy
排除标准
- •Patients with Spontaneously breathing activity
- •Patients undergoing emergent cardiac surgery.
- •Patient with severe peripheral arterial occlusive disease
- •Pregnant women
- •Contraindication of passive leg raising test
- •unstable post-operative course
- •Post-operative complications such as uncontrolled bleeding, severe neurologic impairment, or accidental mechanical complications;
- •presence of residual severe tricuspid or any valvular regurgitations
- •low cardiac output, low ejection fractions (EF ≤45%)
- •open chest,Pao2/Fio2 ≤ 200
研究组 & 干预措施
occlusions test
Combined end expiratory (EEO) and inspiratory occlusion (EIO) test. A 15-s EEO separated by a time window of 1 minute to allow the hemodynamic parameters to return to baseline followed by a 15-s EIO
干预措施: Combined end-expiratory occlusion and end-inspiratory occlusion test (Procedure)
challenge test
Tidal volume (TV) challenge test (transient increase of TV from 6 to 8 mL/kg for 1 minute)
干预措施: Tidal volume challenge test (Procedure)
结局指标
主要结局
The number of volume responder participants could be detected using each fluid responsiveness test
时间窗: immediate postoperative period
The number of volume responder participants could be detected using each fluid responsiveness test including tidal volume challenge test and combined end-expiratory occlusion and end-inspiratory occlusion test
次要结局
未报告次要终点
研究者
tarek abdel hay mostafa
principle investigator
Tanta University