Atrial Natriuretic Peptide in Assessing Fluid Status

Not Applicable

Completed

Conditions: Volume Overload
Cardiac Output, High
Fluid Overload
Cardiac Disease
Cardiac Output, Low
Fluid Loss

Brief Summary: Biomarkers can play a significant role in fluid status assessment intraoperatively.

Detailed Description: Routinely intraoperatively the fluid status assessment is based on central venous pressure and other parameters. Nevertheless, the minority of anesthesiologists use continous dynamic parameters like pulse pressure variation, stroke volume variation and other to manage fluid status. There's a fast acting biomarker that can help anesthesiologist to diagnose and manage the volemic status and possibly guide the infusion therapy better.

Pro-ANP is a biomarker that reacts on atria strain and can be used in volemic status assessment in cardiac surgery patients.

Recruitment & Eligibility

Inclusion Criteria

CABG, one-, two valve repair/replacement, ascending aorta, aortic arch replacement, ASD/AVD closure, septal myectomy

Exclusion Criteria

Atrial fibrillation, atrial flutter, frequent ventricular and supraventricular arrythmias
EFLV < 50%
Pulmonary hypertension > 2 st
CKD > C3 (GFR < 30)
Redo surgery
Left atrium volume > 150 ml
LV EDV > 250 ml

Primary Outcome Measures

Name	Time	Method
Number of Patients With Cardiac Index Rise > 10% After Passive Leg Raising Maneuver	10 minutes of PLR test	Using Massimo vigileo hard- and software the first assessment of cardiac index was made before Teboul test after the trachea intubation. After 10 minutes of passive leg raising maneuver second assessment. If raise in cardiac index above 10 percent was detected the patient was considered a responder. If not - non-responder.
Number of Patients With Pro-ANP Twofold Raise by the End of Surgery	intraoperatively	To assess the atria strain and consequent rise of pro-ANP by the end of surgery
Number of Patients With Pro-ANP Increase > 10% by the PLR Maneuver	intraoperative	According to positive PLR the assessment of pro-ANP consequent raise
Number of Patients With Pro-ANP Increase > 10% by the PLR Maneuver at the End of Surgery	10 minutes of PLR test	Using Massimo vigileo hard- and software the assessment of cardiac index was made before Teboul test at the end of surgery before leaving the operating room. After 10 minutes of passive leg raising maneuver second assessment. If raise in cardiac index above 10 percent was detected the patient was considered a responder. If not - non-responder.

Secondary Outcome Measures

Name	Time	Method
Respiratory Failure	up to 10 days	Number of patients who require prolonged and/or repeated artificial lung ventilation
Renal Failure	up to 10 days	Number of patients who require extracorporeal detoxication
Heart Failure	up to 10 days	Need in medicamental cardiotonic support more than 1 day
Circulatory Insufficiency	up to 10 days	Need in medicamental vasopressor support more than 1 day
Infection Rate	up to 10 days	Number of patients who develop systemic infection and/or operation wound infection
Length of Intensive Care Stay	up to 10 days	Duration of summarized length in ICU, including readmission to ICU
Multiorgan Failure	up to 10 days	Number of more than 2 organs failure
Postoperative Complications	up to 10 days	Total amount of various postoperative complications
Mortality	up to 10 days	Mortality rate

Locations (1): Petrovsky Research National Centre of Surgery (Petrovsky NRCS)
🇷🇺
Moscow, Russian Federation
Petrovsky Research National Centre of Surgery (Petrovsky NRCS)
🇷🇺Moscow, Russian Federation