Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT03455296 |
Other study ID # |
Lactate |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
August 1, 2018 |
Est. completion date |
May 15, 2020 |
Study information
Verified date |
March 2021 |
Source |
National Hepatology & Tropical Medicine Research Institute |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
The aim of this study is to evaluate the efficacy of lactate clearance (LCR) versus central
venous oxygen saturation (ScVO2) to guide fluid management for post-operative patients in the
intensive care unit (ICU).
Description:
Sixty patients will be randomly assigned in a 1:1 manner into two groups; (group A= thirty
patients = ScVO2) & (group B = thirty patients =lactate clearance). Fluid therapy will be
initiated in each group with maintenance in the form of crystalloid e.g. Ringer or Ringer
acetate (in a dose of 30-35 ml/Kg/day) plus replacement with crystalloid e.g. Ringer, Ringer
acetate or saline 0.9%, 500 ml over 10-30 min. that will be administered in boluses [7]
guided by ScVO2with target value ≥ 70% versus lactate clearance (LCR) with target value ≤
2mmol/L (or decline ≥ 10%) by the end of the study in group A & group B respectively with
close regular clinical monitoring/30min., CVP limits 12-16 cmH2O & mean arterial pressure
(MAP) 65-90mmHg. Maintenance fluid without replacement will be initiated alone if ScVO2 or
lactate value normalized or are normal from the start.
All demographic data will be obtained including the patients' age, sex, body mass index
(BMI), associated co-morbidities (diabetes mellitus &hypertension), Sequential Organ Failure
Assessment (SOFA) on admission & discharge from ICU, duration of surgery, the type of
surgery, the amount of blood loss intraoperative, the amount of blood transfused
intraoperative, the need&the amount of blood transfusion postoperative & will be recorded.
Follow-up hemodynamics including the heart rate, mean arterial pressure (MAP), CVP, arterial
oxygen saturation (SaO2), urine volume, fluid balance, blood gases (base excess, PH), hypoxic
index (PaO2/FIO2 ratio) & total fluid infused as a baseline then followed as required.
Monitoring of either lactate level or ScVO2 on admission followed and recorded at regular
intervals during treatment on 0, 2, 6, 12, 24 & 48hours.
Laboratory investigations including the complete blood profile, prothrombin time, liver
functions, serum creatinine & serum electrolytes will be assessed at randomization as a
baseline & then will be recorded as required. Postoperative medical or surgical morbidities
will be followed during ICU & hospital stay e.g. weight gain, impairment of hypoxic index
(P/F ratio), pulmonary edema, pleural effusion, need for mechanical ventilation, paralytic
ileus, renal impairment& intra-abdominal bleeding.28-day mortality will be asked for &
followed by calling the telephone number of the patient or one of his/her first-degree
relatives.