Medical Oncology Clinical Trial
Official title:
Measurement of Cardiac Index by Transpulmonary Thermodilution Using an Implanted Central Venous Access Port: a Prospective Study in Patients Scheduled for Oncologic High-risk Surgery
Perioperative hemodynamic optimization requires monitoring adapted to the risks of the
surgery and the patient. The investigators currently use a local hemodynamic protocol based
on the data of the literature. According to this protocol, specific patients may require
cardiac index and central venous oxygen saturation monitoring. the investigators chose to
monitor the cardiac index (CI) with the transpulmonary thermodilution technique (TPTD)
(PiCCO, Pulsion Medical System, Munich, Allemagne). The technique is based on the injection
of a cooled bolus of saline into a central vein with a central venous catheter (CVC). The
variation of temperature is measured with an arterial femoral catheter and allows the
assessment of the cardiac output according to Stewart-Hamilton's theory. Many studies showed
the reliability of this technique (Bein J Cardio Thorac Vasc Anesth 2004, Buhre Cardio
thorac vasc anesth 1999, Felbinger J Clin ANesth 2005, Felbinger TW J Clin Anetsh 2002,
Godie O Ann Thorac Surg 1999).
In our institute, most of the patients are fitted with a port for chemotherapy or parenteral
nutrition. When PiCCO monitoring is necessary, a central venous catheter is inserted on the
opposite side of the permanent implantable venous port. Indeed, insertion of the CVC can be
more difficult because of the port. It may be interesting to use the port for TPTD in order
to avoid the insertion of a new CVC. This would be possible only if the measurement of CI by
the port was as reliable as the classical measurement with a CVC.
The aim of this study was to assess whether measurement of the CI by TPTD was possible and
reliable via the port. The investigators conducted a prospective study comparing the
measurement of the CI by TPTD before and after fluid challenge via the port versus the CVC.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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