Fluid Responsiveness Assessment in Adult Neurosurgical Patients Undergoing Posterior Fossa Tumor Resection in the Park Bench Position: a Comparison Between Pulse Pressure Variation (PPV) and Central Venous Pressure (CVP) Guidance
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Total intraoperative fluid administration volumes during surgery
研究概览
简要总结
To answer the question: What are the differences in intraoperative fluid administration volumes between PPV and CVP-guided strategies during posterior fossa tumor resection in the park bench position?
详细描述
Prospective RCT is conducted to compared the amount of fluid volume in adult patients undergoing posterior fossa surgery in park bench position.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
Outcome assessor received the anesthetic record form by unknown of the patient and group allocation.
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
- •Adult patients aged 18 years and above
- •American Society of Anesthesiologists (ASA) I and II
- •Diagnosis of posterior fossa tumor requiring surgical resection in the park bench position, under general anesthesia at our hospital
- •Willing to participate in the study
排除标准
- •Significant cardiac diseases
- •Chronic obstructive airway disease
- •Elevated intra-abdominal pressure
- •Tumors prone to precipitate diabetes insipidus
- •Peripheral vascular disease
- •Pulmonary hypertension
- •Patients in sepsis
研究组 & 干预措施
Pulse pressure variation guidance fluid administration
In the PPV group, fluids will be administered to maintain the PPV below 13%. If hypotension coincided with a PPV exceeding 13%, an initial bolus of 200 ml crystalloid fluid solution will be given in10 minutes. PPV reassessment occurred within the subsequent 10 minutes. Alternatively, if hypotension occurs with a PPV measuring less than 13%, vasopressors such as ephedrine at a dose of 3-6 mg or norepinephrine at a dosage of 5-10 mcg intravenously as a bolus, or norepinephrine infusion at a rate of 0.03-0.3 mcg/kg/min, will be given to sustain mean arterial pressure above 65 mmHg.
干预措施: Pulse pressure variation (Procedure)
Central venous pressure guidance fluid administration
In the CVP group, intraoperative fluid administration aimed to maintain CVP between 8-12 cmH2O while on mechanical ventilation, ensuring mean arterial pressure remains above 65 mmHg and heart rate within 20% of baseline.
干预措施: Central venous pressure (Procedure)
结局指标
主要结局
Total intraoperative fluid administration volumes during surgery
时间窗: during surgery
fluid and blood and blood volume transfusion during surgery
次要结局
- vital signs(during the admission in neurosurgical ICU up to 3 days after surgery)
- time to extubation(48 hours after surgery at the neurosurgical intensive care unit)
- vital signs(during surgery, the data will be recorded every 5 minutes throughout the procedure)
研究者
Pathomporn Pin on, M.D.
Associate Professor Pathomporn Pin on
Chiang Mai University