Spectral Analysis of Central Venous Pressure Waveform
- Conditions
- Donor HepatectomyCentral Venous CatheterHypovolemia
- Interventions
- Procedure: Placement of a central venous catheterDevice: Monitoring of central venous pressureDrug: Furosemide-induced hypovolemia before graft procurementDrug: Replacement of fluid loss after graft procurementDevice: Monitoring of stroke volume variation
- Registration Number
- NCT04733547
- Lead Sponsor
- JongHae Kim
- Brief Summary
The use of central venous pressure has been abandoned for the assessment of intravascular volume status. The dynamic fluctuation of central venous pressure according to heart rate is quantitatively measured by spectral analysis of the central venous pressure waveform. Its clinical utility in the assessment of intravascular volume status is investigated.
- Detailed Description
The use of central venous pressure, which is one of the static preload indices, has been abandoned for the assessment of intravascular volume status because of its unreliability. The static preload indices have been replaced with dynamic preload indices, such as stroke volume variation or pulse pressure variation because the dynamic preload indices reliably predict fluid responsiveness and perform better than the static preload indices. However, the periodic component of central venous pressure, which goes with cardiac cycles, has not been investigated. The power corresponding to heart rate from spectral analysis of central venous pressure waveform represents the extent of the dynamic fluctuation of central venous pressure and is assumed to reflect intravascular volume status. It is hypothesized that the spectral power of central venous pressure corresponding to heart rate represents intravascular volume status.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- American Society of Anesthesiologists physical status 1
- Scheduled for donor hepatectomy under general anesthesia
- Arrhythmia
- Valvular heart disease
- Coronary artery disease
- Cerebrovascular disease
- Hypertension
- Diabetes mellitus
- Renal insufficiency
- Pulmonary problems
- Any type of liver disease
- Body mass index greater than 35 kg/m2
- Human immunodeficiency virus infection
- Psychosocial problems
- Electrolyte imbalance
- Reoperation
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Donor hepatectomy Replacement of fluid loss after graft procurement Live donors undergoing hepatectomy Donor hepatectomy Placement of a central venous catheter Live donors undergoing hepatectomy Donor hepatectomy Monitoring of central venous pressure Live donors undergoing hepatectomy Donor hepatectomy Furosemide-induced hypovolemia before graft procurement Live donors undergoing hepatectomy Donor hepatectomy Monitoring of stroke volume variation Live donors undergoing hepatectomy
- Primary Outcome Measures
Name Time Method Spectral power of central venous pressure corresponding to heart rate during 5 minutes before graft procurement During 5 minutes before graft procurement A band-pass filter (0.15-3 Hz) is applied to the 5 minute-long segment. The 5 minute-long segments are divided into 100 second-long segments overlapping 50% with each adjacent segment. Each segment is submitted to fast Fourier transformation. The spectral powers obtained from the periodograms of each segment are averaged. The integrated area corresponding to heart rate is the spectral power corresponding to heart rate.
- Secondary Outcome Measures
Name Time Method Spectral powers of central venous pressure corresponding to respiratory rate and heart rate during 5 minutes before the first dose of furosemide During 5 minutes before the first dose of furosemide A band-pass filter (0.15-3 Hz) is applied to the 5 minute-long segment. The 5 minute-long segments are divided into 100 second-long segments overlapping 50% with each adjacent segment. Each segment is submitted to fast Fourier transformation. The spectral powers obtained from the periodograms of each segment are averaged. The integrated areas corresponding to respiratory rate and heart rate are the spectral powers corresponding to respiratory rate and heart rate.
Spectral powers of central venous pressure corresponding to respiratory rate and heart rate between 30 and 35 minutes after surgical incision Between 30 and 35 minutes after surgical incision A band-pass filter (0.15-3 Hz) is applied to the 5 minute-long segment. The 5 minute-long segments are divided into 100 second-long segments overlapping 50% with each adjacent segment. Each segment is submitted to fast Fourier transformation. The spectral powers obtained from the periodograms of each segment are averaged. The integrated areas corresponding to respiratory rate and heart rate are the spectral powers corresponding to respiratory rate and heart rate.
Spectral power of central venous pressure corresponding to respiratory rate during 5 minutes before graft procurement During 5 minutes before graft procurement A band-pass filter (0.15-3 Hz) is applied to the 5 minute-long segment. The 5 minute-long segments are divided into 100 second-long segments overlapping 50% with each adjacent segment. Each segment is submitted to fast Fourier transformation. The spectral powers obtained from the periodograms of each segment are averaged. The integrated area corresponding to respiratory rate is the spectral power corresponding to respiratory rate.
Spectral powers of central venous pressure corresponding to respiratory rate and heart rate during 5 minutes after administration of 6% hydroxyethyl starch During 5 minutes after administration of 6% hydroxyethyl starch A band-pass filter (0.15-3 Hz) is applied to the 5 minute-long segment. The 5 minute-long segments are divided into 100 second-long segments overlapping 50% with each adjacent segment. Each segment is submitted to fast Fourier transformation. The spectral powers obtained from the periodograms of each segment are averaged. The integrated areas corresponding to respiratory rate and heart rate are the spectral powers corresponding to respiratory rate and heart rate.
Stroke volume variation during 5 minutes before the first dose of furosemide During 5 minutes before the first dose of furosemide The median of the values calculated at a 20-second interval
Stroke volume index during 5 minutes before the first dose of furosemide During 5 minutes before the first dose of furosemide The median of the values calculated at a 20-second interval
Cardiac index during 5 minutes before the first dose of furosemide During 5 minutes before the first dose of furosemide The median of the values calculated at a 20-second interval
Stroke volume variation between 30 and 35 minutes after surgical incision Between 30 and 35 minutes after surgical incision The median of the values calculated at a 20-second interval
Stroke volume index between 30 and 35 minutes after surgical incision Between 30 and 35 minutes after surgical incision The median of the values calculated at a 20-second interval
Cardiac index between 30 and 35 minutes after surgical incision Between 30 and 35 minutes after surgical incision The median of the values calculated at a 20-second interval
Stroke volume variation during 5 minutes before graft procurement During 5 minutes before graft procurement The median of the values calculated at a 20-second interval
Stroke volume index during 5 minutes before graft procurement During 5 minutes before graft procurement The median of the values calculated at a 20-second interval
Cardiac index during 5 minutes before graft procurement During 5 minutes before graft procurement The median of the values calculated at a 20-second interval
Stroke volume variation during 5 minutes after administration of 6% hydroxyethyl starch During 5 minutes after administration of 6% hydroxyethyl starch The median of the values calculated at a 20-second interval
Stroke volume index during 5 minutes after administration of 6% hydroxyethyl starch During 5 minutes after administration of 6% hydroxyethyl starch The median of the values calculated at a 20-second interval
Cardiac index during 5 minutes after administration of 6% hydroxyethyl starch During 5 minutes after administration of 6% hydroxyethyl starch The median of the values calculated at a 20-second interval
Total dose of furosemide At graft procurement The total dose of furosemide used for the promotion of diuresis
Urine output at graft procurement At graft procurement The total amount of urine output between the placement of urinary catheter and graft procurement
Total urine output at the end of surgery At the end of surgery The total amount of urine output at the end of surgery
Intraoperative blood loss 1 day after surgery Calculated as blood loss (ml) = \[estimated blood volume\*(preoperative hematocrit-postoperative hematocrit)\]/mean between the 2 hematocrit values, where estimated blood volume (ml) = weight(kg)\^0.425\*height(cm)\^0.725\*0.007184\*2217+age(years)\*1.06 for female and weight(kg)\^0.425\*height(cm)\^0.725\*0.007184\*3064-825 for male
Trial Locations
- Locations (1)
Daegu Catholic University Medical Center
🇰🇷Daegu, Korea, Republic of