Spectral Analysis of Central Venous Pressure Waveform in Patients Undergoing Donor Hepatectomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Spectral power of central venous pressure corresponding to heart rate during 5 minutes before graft procurement
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •American Society of Anesthesiologists physical status 1
- •Scheduled for donor hepatectomy under general anesthesia
排除标准
- •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
研究组 & 干预措施
Donor hepatectomy
Live donors undergoing hepatectomy
干预措施: Placement of a central venous catheter (Procedure)
Donor hepatectomy
Live donors undergoing hepatectomy
干预措施: Monitoring of central venous pressure (Device)
Donor hepatectomy
Live donors undergoing hepatectomy
干预措施: Furosemide-induced hypovolemia before graft procurement (Drug)
Donor hepatectomy
Live donors undergoing hepatectomy
干预措施: Replacement of fluid loss after graft procurement (Drug)
Donor hepatectomy
Live donors undergoing hepatectomy
干预措施: Monitoring of stroke volume variation (Device)
结局指标
主要结局
Spectral power of central venous pressure corresponding to heart rate during 5 minutes before graft procurement
时间窗: 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.
次要结局
- 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)
- 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)
- Spectral power of central venous pressure corresponding to respiratory rate during 5 minutes before graft procurement(During 5 minutes before graft procurement)
- 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)
- Stroke volume variation during 5 minutes before the first dose of furosemide(During 5 minutes before the first dose of furosemide)
- Stroke volume index during 5 minutes before the first dose of furosemide(During 5 minutes before the first dose of furosemide)
- Cardiac index during 5 minutes before the first dose of furosemide(During 5 minutes before the first dose of furosemide)
- Stroke volume variation between 30 and 35 minutes after surgical incision(Between 30 and 35 minutes after surgical incision)
- Stroke volume index between 30 and 35 minutes after surgical incision(Between 30 and 35 minutes after surgical incision)
- Cardiac index between 30 and 35 minutes after surgical incision(Between 30 and 35 minutes after surgical incision)
- Stroke volume variation during 5 minutes before graft procurement(During 5 minutes before graft procurement)
- Stroke volume index during 5 minutes before graft procurement(During 5 minutes before graft procurement)
- Stroke volume index during 5 minutes after administration of 6% hydroxyethyl starch(During 5 minutes after administration of 6% hydroxyethyl starch)
- Stroke volume variation during 5 minutes after administration of 6% hydroxyethyl starch(During 5 minutes after administration of 6% hydroxyethyl starch)
- Cardiac index during 5 minutes before graft procurement(During 5 minutes before graft procurement)
- Cardiac index during 5 minutes after administration of 6% hydroxyethyl starch(During 5 minutes after administration of 6% hydroxyethyl starch)
- Total dose of furosemide(At graft procurement)
- Urine output at graft procurement(At graft procurement)
- Total urine output at the end of surgery(At the end of surgery)
- Intraoperative blood loss(1 day after surgery)
研究者
JongHae Kim
Professor
Daegu Catholic University Medical Center