Pneumoperitoneum Clinical Trial
— SPV-PnPOfficial title:
Clinical Trial for Evaluation of Arterial and Plethysmographic Waveform Variations as Predictors of Hemodynamic Response to Pneumoperitoneum During Laparoscopic Surgery
Laparoscopic surgery is frequently associated with hemodynamic changes due to
pneumoperitoneum (PnP). Those complex hemodynamic changes are difficult to predict and
occasionally they require active therapeutic interventions or even interruption of the
surgical procedure.
One of the main hemodynamic effects of PnP is a decrease in cardiac output due to reduction
of venous return and cardiac preload. Although it has been shown repeatedly that waveform
variables are good predictors of cardiac output response to volume loading, the prediction
hemodynamic response to decrease of preload is more complex.
The investigators hypothesize that waveform variables will predict cardiac output changes
resulting from PnP. Particularly, augmented values of waveform variables before PnP will be
associated with a larger decrease of cardiac output after establishing PnP.
Status | Recruiting |
Enrollment | 150 |
Est. completion date | November 2016 |
Est. primary completion date | November 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - The patients scheduled for elective laparoscopic partial hepatectomy, laparoscopic splenectomy, laparoscopic pancreatectomy - required of continuous direct blood pressure monitoring according to the type of surgery - The patients ASA class III-IV scheduled for elective laparoscopic colectomy and hemicolectomy - required of continuous direct blood pressure monitoring according to their medical condition - Pneumoperitoneum by needle application only - Normal sinus cardiac rhythm Exclusion Criteria: - Patients that didn't sign informed consent - Patients ASA class I-II scheduled for elective laparoscopic colectomy or hemicolectomy - Patients scheduled for elective laparoscopic cholecystectomy - Patients required of monitoring by pulmonary artery catheter during the surgery according to their medical condition |
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Country | Name | City | State |
---|---|---|---|
Israel | The Lady Davis Carmel Medical Center | Haifa |
Lead Sponsor | Collaborator |
---|---|
Carmel Medical Center |
Israel,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Plethysmographic Waveform Variation (PWV) | Plethysmographic Waveform Variation will be measured before applying of pneumoperitoneum, 2-5 min after applying of pneumoperitoneum with intraabdominal pressure of 15 mmHg and 2-5 min after decrease of intraabdominal pressure until 10 mmHg | Change of intraabdominal pressure before and 2-5 min after pneumoperitoneum | No |
Primary | Cardiac output/cardiac index | Cardiac output/cardiac index will be measured before applying of pneumoperitoneum, 2-5 min after applying of pneumoperitoneum with intraabdominal pressure of 15 mmHg and 2-5 min after decrease of intraabdominal pressure until 10 mmHg | Change of intraabdominal pressure before and 2-5 min after pneumoperitoneum | No |
Secondary | Systolic pressure variation (SPV)/Pulse pressure variation (PPV) | Systolic pressure variation/Pulse pressure variation will be measured before applying of pneumoperitoneum, 2-5 min after applying of pneumoperitoneum with intraabdominal pressure of 15 mmHg and 2-5 min after decrease of intraabdominal pressure until 10 mmHg | Change of intraabdominal pressure before and 2-5 min after pneumoperitoneum | No |
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