Transesophageal Echocardiography as a Guide for Fluid Optimization in Major Abdominal Oncosurgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Fluid Therapy
- Sponsor
- Rajiv Gandhi Cancer Institute & Research Center, India
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Postoperative complications
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Transesophageal echocardiography (TEE) as guide for tailoring perioperative fluid therapy to achieve individualized hemodynamic endpoint, target hemodynamic goals of stroke volume index (SVI) greater than 35 mL/m2 and cardiac index greater than 2.5 L/min/m2 and tissue oxygen delivery.
Lactate levels as a surrogate indicator of organ perfusion as measured by arterial blood gas analysis intraoperatively, after 12 hours and 48 hrs postoperatively
Detailed Description
TEE as guide for tailoring perioperative fluid therapy to achieve target hemodynamic goals of stroke volume index (SVI) greater than 35 mL/m2 and cardiac index greater than 2.5 L/min/m2 and tissue oxygen delivery. GDT (goal directed therapy): continuous infusion of crystalloids 2 mL/kg/h. If (velocity time integral) VTI \<20, 250 mL colloid bolus administered. Dose repeated every 10 min until goal of VTI \>20 met. Norepinephrine titrated to maintain MAP(mean arterial pressure) \> 65 mm Hg. Blood transfused for haemoglobin \<8 g Lactate levels as a surrogate indicator of organ perfusion as measured by arterial blood gas analysis at time of incision intraoperatively and after 12 hours and 48 hrs. The incidence of postoperative complications, morbidity, mortality, duration of mechanical ventilation and ICU stay.
Investigators
Dr soumi pathak
Principal Investigator
Rajiv Gandhi Cancer Institute & Research Center, India
Eligibility Criteria
Inclusion Criteria
- •ASA 1, 2 and 3
- •Undergoing major abdominal oncosurgery
Exclusion Criteria
- •Any contraindication for TEE probe insertion as oesophageal varices , oesophageal and gastric carcinoma , severe left ventricular hypertrophy , coagulopathy.
Outcomes
Primary Outcomes
Postoperative complications
Time Frame: 48 hours
The incidence of postoperative complications in percentage
Secondary Outcomes
- intraoperative fluid(intraoperative period (hours))
- median icu stay(1 week)