The Effect of Fluid Management by SVV of FloTrac/ Vigileo™ Monitoring on Postoperative Recovery in Bowel Resection

Bowel Resection Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02288767
• Other study ID #: 4-2014-0730
• Status: Completed
• Phase: N/A
• First received: November 3, 2014
• Last updated: September 12, 2017
• Start date: March 9, 2015
• Est. completion date: August 15, 2017

Study information

• Verified date: September 2017
• Source: Yonsei University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

During an enterectomy, especially in an open surgery, large amounts of fluid are administered in consideration of the patient's fasted state, maintaining blood pressure during surgery and potential third space loss. However, it has recently been reported that excessive fluid administration during surgery is actually detrimental to patients' prognoses. In fact, several reports have suggested that compared to limited fluid administration, excessive fluid administration increased the length of stay or the chances of complications. Thus, goal-directed fluid optimization is required during surgery because only a proper amount of fluid (neither limited nor excessive) administration can minimize postoperative complications and enhance prognosis. In general, the amount of fluid administered is determined with regard to the patient's volume status, including a comprehensive assessment of vital signs such as the pulse rate and blood pressure, and urine volume. However, this method has limitations in that it is an inadequate indicator of the actual intravascular volume of a patient to determine and administer the proper amount of fluid. Recently, new methods of measuring volume status that are less invasive and more accurate have been introduced. These methods include stroke volume variation (SVV) that monitors changes in arterial pressure waveform amplitudes with regard to breathing patterns. This is an effective method of monitoring fluid responsiveness after placing a catheter via a radial artery puncture. The stroke output is dependent on the preload, afterload, and cardiac contractility. The cardiac output is determined by multiplying the stroke output and heart rate. SVV indicates the difference in stroke output within one breathing cycle. A direct or indirect measurement of stroke output is required, which can be performed by analyzing arterial pressure waveforms via a FloTrac Sensor (Edwards Lifesciences, USA) monitor. SVV is known to have a high fluid responsiveness even during open surgeries, yet there is practically no research data on its effect in patients' postoperative recovery and prognosis in comparison to the traditional methods of fluid administration. Therefore, the investigators will apply SVV via a FloTrac/ Vigileo™ monitor on patients undergoing bowel resection to determine whether it better assists proper fluid administration compared to the traditional method of fluid administration by examining the patients' postoperative prognosis such as bowel movement recovery and length of stay.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 62
• Est. completion date: August 15, 2017
• Est. primary completion date: August 15, 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years to 70 Years

Eligibility

Inclusion Criteria:

• Patients aged 20 to 70 scheduled to undergo bowel resection open surgery below the ASA class 3

Exclusion Criteria:

• Patients with significant impairments in heart, kidney, and liver functions

• Patients with arrhythmia such as tachycardia and atrial fibrillation or patients on pacemakers

• Patients diagnosed with peripheral arterial disease or are Allen's test positive

• Patients who underwent surgery on the identical surgical area

• Patients with obesity

• Patients with blood coagulation impairments

Related Conditions & MeSH terms

• Bowel Resection

Intervention

Device:
• Conventional arterial blood pressure monitoring

• Stroke volume variation monitoring with arterial blood pressure monitoring

Locations

Country	Name	City	State
Korea, Republic of	Yonsei University, College of Medicine, Yonsei Health System, Yonsei Cancer Center	Seoul

Sponsors (1)

Lead Sponsor	Collaborator
Yonsei University

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Recovery of bowel movement - gas passing time after bowel resection	To evaluate the difference in bowel movement recovery whether using SVV or not on the fluid management in the patients undergoing open enterectomy, the difference of postoperative gas passing time will be compared.	24 hous