Hemodynamic (MAP) Stability Clinical Trial
Official title:
Feasibility of Computer-assisted Vasopressor Infusion Using Continuous Noninvasive Blood Pressure Monitoring in High-risk Patients Undergoing Renal Transplant Surgery
Intraoperative hypotension and blood pressure variability are associated with postoperative
complications in surgical patients.
The investigators have developed a closed-loop vasopressor (CLV) controller that titrates
norepinephrine to correct hypotension.
After having tested the system in a small cohort series of patients undergoing major
surgeries, the investigators aimed to test the feasibility of the CLV controller guided
noninvasively and continuously with the ClearSight system (Edwards Lifesciences, USA) in
three high risk patients undergoing renal transplant surgery
Intraoperative hypotension is frequent in patients undergoing surgery and can negatively
impact organ perfusion.
The investigators have developed a closed-loop vasopressor (CLV) controller to more
efficiently correct hypotension.
The investigators tested it extensively in preclinical studies and recently demonstrated its
feasibility and excellent performance metrics in a short series of high-risk patients
undergoing major surgical procedures.
In these studies, the controller was linked to a minimally-invasive advanced hemodynamic
monitoring device utilizing an arterial line which then controlled a vasopressor infusion.
However, the vast majority of patients who undergo surgery do not require an arterial line
but should still benefit from rapid corrections of hypotensive episodes that are less rapidly
detected via an intermittent non-invasive blood pressure cuff. Fortunately, completely
noninvasive technology now allows us to continuously monitor blood pressure and therefore
extend the use of our closed-loop vasopressor system to patients in whom an arterial catheter
would not typically be placed. Patients undergoing renal transplant surgeries are the ideal
patient population.
The investigators aimed to test the feasibility of guiding our CLV controller with a
continuous noninvasive blood pressure monitoring device (ClearSight system, Edwards
Lifesciences, Irvine, CA, USA) in three patients (case series)
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