Comparison of the Effects of Trendelenburg Position and Passive Leg Lift on Hemodynamics in Abdominal Surgery Patients
试验速览
- 阶段
- 不适用
- 入组人数
- 54
- 试验地点
- 1
- 主要终点
- PPV(pulse pressure variation)
研究概览
简要总结
How to maintain the stability of circulation during anesthesia has always been a concern of clinicians, including shorting the preoperative fasting time under the condition of full preoperative preparation, and giving appropriate amount of nutrient solution in combination with the patient's situation 2~4 h before surgery to reduce the blood volume insufficiency of patients before general anesthesia induction, vasoactive drugs, etc. Among them, passive leg lifting experiment is widely recognized in the world. Although passive leg lifting has many advantages, it still has some limitations in the operation process. This study tried to find the corresponding head low and foot high Angle corresponding to the same hemodynamic changes caused by passive leg lifting.
详细描述
For low head and high feet, studies have shown that 20° can reduce the incidence of hypotension during the induction period of general anesthesia in patients undergoing gastrectomy and has therapeutic effect on it, as well as reduce the use of vasoactive drugs during the induction period of general anesthesia. There were no perioperative complications.
The passive leg lift test can be repeated and does not overload the patient with fluid. However, there is no relevant research on the relationship between the two, which is exactly the innovation of this topic.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18~75 years old
- •Good image of TTE can be obtained
- •Sedative mechanical ventilation （Vt 8～10ml/kg）
- •Circulation was relatively stable before the experiment began
- •There is no contraindication to rehydration
排除标准
- •TTE acquisition is not ideal
- •Patients did not agree to participate in the experiment
- •Diseases of the central nervous system，patients with increased intracranial pressure
- •Arrhythmia patients;
- •Patients with increased intra-abdominal pressure;
- •Bedridden patients;
- •Patients with venous thrombosis of lower limbs;
- •Patients with venous foreign body of lower limbs;
- •Patients with circulatory instability;
- •Patients with obstructive shock;
- •Patients with moderate or above heart valve reflux
结局指标
主要结局
PPV(pulse pressure variation)
时间窗: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
Change from PPV at T1to T6
VTI(velocity time integral)
时间窗: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
Change from VTI at T1 to T6
次要结局
- SBP(Systolic Blood Pressure)(T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion)
- MAP(Mean Artery Pressure)(T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion)
- HR HR(Heart Rate)(T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion)