Preload Dependency Evaluation With Stroke Volume Variation During Alveolar Recruitment Manoeuvres
- Conditions
- Coronary Artery DiseaseHypovolemiaAnesthesia, GeneralPulmonary AtelectasisCoronary Artery Bypass
- Interventions
- Other: tee measurementOther: flotrac measurementOther: clearsight measurement
- Registration Number
- NCT02678559
- Lead Sponsor
- University Hospital, Clermont-Ferrand
- Brief Summary
The principal aim is to assess impact of alveolar recruitment manoeuvres (ARM) on stroke volume variation, evaluated by trans-oesophageal echocardiography (TEE). These variations will be measured on preload dependency or preload independency status. The principal purpose is to determine if variations of stroke volume during standardized ARM can predict the preload dependency status.
- Detailed Description
Population studied: anesthetized patients for cardiac surgery of coronary bypass.
Secondary endpoints : - comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. These mini-invasive systems are : Clearsight system (Edwards Lifescience) and Flotrac system (Edwards Lifescience)
- Difference between pre and post-cardiopulmonary bypass status on principal purpose evaluation
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 24
- Adult patient Undergoing a surgical procedure of coronary artery bypass, with cardiopulmonary bypass Written consent collected
- Emergency case
- Pericardial effusion
- Aortic or mitral valvulopathy
- Contraindication for : TEE, alveolar recruitment manoeuvre (emphysema, pneumothorax, hemodynamic instability), Ringer Lactate solution infusion
- Bad echogenicity
- Patient refusal to participate to the study
- No health insurance
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description TEE monitory system tee measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. mini-invasive monitoring system clearsight measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. TEE monitory system flotrac measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. mini-invasive monitoring system flotrac measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. TEE monitory system clearsight measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM. mini-invasive monitoring system tee measurement comparison between TEE and mini-invasive monitoring systems in accuracy of measurement of stroke volume variation during ARM.
- Primary Outcome Measures
Name Time Method Variation of stroke volume at the beginning of cardiac surgery Variation of stroke volume measured by TEE, induced by a standardized ARM, at the beginning of cardiac surgery
- Secondary Outcome Measures
Name Time Method Pulse pressure variation (%) (Clearsight measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Perfusion index (pulsoxymeter) After the cardiopulmonary bypass period, when sternotomy will be closed Right ventricle diameter/left ventricle diameter ratio After the cardiopulmonary bypass period, when sternotomy will be closed Right ventricle diameter/left ventricle diameter ratio (TEE measurement),
Cardiac index (l/min/m2) After the cardiopulmonary bypass period, when sternotomy will be closed Cardiac index (l/min/m2) (TEE measurement)
E/A ratio After the cardiopulmonary bypass period, when sternotomy will be closed E/A ratio (TEE measurement)
Sus-hepatic vein Doppler profile After the cardiopulmonary bypass period, when sternotomy will be closed Sus-hepatic vein Doppler profile (TEE measurement)
Heart rate (pulse/min) After the cardiopulmonary bypass period, when sternotomy will be closed Invasive arterial pressure (mmHg) After the cardiopulmonary bypass period, when sternotomy will be closed Velocity time integral (cm) After the cardiopulmonary bypass period, when sternotomy will be closed Velocity time integral (cm) (TEE measurement)
Stroke volume variation (%) (Clearsight measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Cardiac index (l/min/m2) (Clearsight measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Expired CO2 (mmHg) After the cardiopulmonary bypass period, when sternotomy will be closed Central venous pressure (mmHg) After the cardiopulmonary bypass period, when sternotomy will be closed Stroke volume (ml) (Flotrac measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Stroke volume variation (%) (Flotrac measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Arterial pressure (mmHg) (Flotrac measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Stroke volume (ml) (Clearsight measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Pulse pressure variation (%) After the cardiopulmonary bypass period, when sternotomy will be closed Cardiac index (l/min/m2) (Flotrac measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Near infrared spectroscopy : Cerebral SrO2 After the cardiopulmonary bypass period, when sternotomy will be closed Arterial pressure (mmHg) (Clearsight measurement) After the cardiopulmonary bypass period, when sternotomy will be closed Pulse pressure variation (%) (Flotrac measurement) After the cardiopulmonary bypass period, when sternotomy will be closed
Trial Locations
- Locations (1)
CHU Clermont-Ferrand
🇫🇷Clermont-Ferrand, France