Fluid Response Clinical Trial
Official title:
The Accuracy of Pleth Variability Index for Directed Fluid Optimization in Donors in Living Donor Liver Transplantation
In this Study we are trying to validate the accuracy of Plethogram variability index in predicting fluid responsiveness compared to pulse pressure variation in donors of liver transplantation
The liver transplantation program at Ain Shams University Hospitals relies on related living
donors. Extra care during anesthetic management of the donor is warranted because of clear
ethical considerations.
This prospective observational study was performed after obtaining approval from the ethical
committee of the Ain Shams University FWA R 53/2018. Sample of 40 healthy ASA I or II donors'
candidate for right lobe hepatectomy for living donor liver transplantation (LDLT) were
included and consent was taken. Conventional form of anesthesia was induced with left radial
arterial line inserted for invasive blood pressure monitoring, frequent blood gases and
lactate sampling, and measuring the PPV, Right insertion of internal jugular vein line for
CVP measurement. Fluid management in the form of ringer acetate 3-5 ml/kg/hr recruitment of
the patients (Hypovolemic donors) depends on the presenting signs that led the
anesthesiologist to decide if the patient's volume status was hypovolemic and in need for
fluid replacement without presence of surgical mechanical compression on the IVC or Liver
during dissection phase. These diagnostic criteria for volume assessment were heart rate (HR)
more than 100 beats/min, systolic arterial blood pressure (SAP) less than 90 mmHg.
Assessment of Hemodynamics during periods of Hypovolemia After exclusion of any surgical
mechanical compression, all enrolled hypovolemic patients had left radial arterial line
measuring PPV using Drager Monitor and a pulse oximeter measuring PVI using Device Masimo.
This device measures the perfusion index which is the indicator of the amplitude of the
signal of PVI, confirmation of the wave signal should be obtained from any finger, fingers
should be kept warm before test is done. Hypovolemic patients were given a fluid bolus in the
form of ringer acetate 5 ml / Kg over 10 minutes. At the end of volume expansion another
recorded PPV and PVI are done. Primary outcome was the correlation between PPV and PVI before
and after fluid resuscitation
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Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT01329146 -
Pulse Pressure Variations as Index of Preload Dependency During Thoracic Surgery
|
N/A |