Anesthesia Clinical Trial
Official title:
Changes in Measured Plasma Volume, Glycocalyx and Atrial Natriuretic Peptide During Anaesthesia, a Randomised Clinical Trial
The arterial blood pressure is thought to affect the ratio between filtration and reabsorption of fluids in the circulating blood volume and thereby the plasma volume. During induction of anesthesia blood pressure, hemoglobin level and hematocrits decreases and the plasma volume increases. The aim of the study is to evaluate weather a maintained blood pressure with norepinephrine during anesthesia induction reduces the increase in 125 iodine-labeled human serum albumine (125I-HSA) measured plasma volume.
24 patients scheduled for coronary artery bypass surgery will be included and randomized to
receive either norepinephrine in the dose needed to maintain pre-anesthesia blood pressure or
to a control group and receive norepinephrine only if mean arterial pressure decreases below
60 mmHg. Equal anesthesia in both groups will be monitored. No fluids will be infused.
Changes in vascular resistance and cardiac output will be measured with thermodilution and
changes in plasma volume will be measured with 125I-HSA.
Endothelial cell function will be evaluated by measuring leakage of 125I-HSA and the plasma
concentration of endothelial cell markers. Hormonal effects will be evaluated by measuring
the plasma concentration of atrial natriuretic peptide (ANP). Shedding of glycocalyx will be
evaluated by measuring heparan sulphate. The level of fibrinogen and platelet function will
be evaluated by thromboelastography/multiplate.
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