Hemodynamics Clinical Trial
Official title:
Assessment of Fluid Responsiveness in Patients After Cardiac Surgery Comparison of Different Functional Hemodynamic Parameters and Tests
To overcome the limited accuracy of functional hemodynamic parameters such as stroke volume
and pulse pressure variation (SVV and PPV) during spontaneous breathing, a Passive Leg
Raising (PLR) manoeuvre has been suggested as a reliable predictor of fluid responsiveness.
Aim of this study was to evaluate fluid responsiveness using SVV, PPV and PLR during the
transition from controlled to spontaneous breathing in cardiac surgery patients
In patients after elective off-pump CABG are enrolled hemodynamic measurements are performed
in the postoperative period upon arrival in the ICU using a PiCCO2 system (Pulsion Medical
Systems, Munich, Germany).
Controlled fluid challenges (500 ml) are done at 3 time-points:
A) during controlled mechanical ventilation B) during pressure support ventilation with
spontaneous breathing and C) after extubation.
Stroke volume (SV), SVV and PPV as well as standard hemodynamic parameters (MAP = mean
arterial pressure, HR = heart rate) are assessed.
A PLR is performed before fluid administration at all 3 time points. A positive response is
defined as an increase in SV>15 %.
Prediction of fluid responsiveness will be tested by AUC (area under the receiver operating
characteristic - ROC - curve).
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Observational Model: Case-Only, Time Perspective: Prospective
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