Cardiac Output, Low Clinical Trial
— RACEOfficial title:
The Effect of Epinephrine, Norepinephrine and Phenylephrine on Intraoperative Hemodynamic Performance - a Prospective Double-blinded Randomized Clinical Trial
The use of catecholamines for blood pressure and hemodynamic management is essential during undergoing surgery. The type of the catecholamine with the most clinical meaningful effect is still unknown. Therefore, the investigators evaluate the effect of intraoperative continuous infusion of epinephrine, norepinephrine and phenylephrine on intraoperative cardiac output. The investigators further evaluate the effect of epinephrine, norepinephrine and phenylephrine on regional brain and regional tissue oxygenation during surgery.
Status | Recruiting |
Enrollment | 225 |
Est. completion date | August 31, 2024 |
Est. primary completion date | August 1, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 45 Years to 90 Years |
Eligibility | Inclusion Criteria: - = 45 years old - Scheduled for moderate- to high-risk major open abdominal surgery expected to last at least two hours - ASA physical status = 2 - At least one of the following risk factors: 1. Age =75years 2. History of peripheral arterial disease 3. History of coronary artery disease 4. History of stroke or transient ischemic attack/Stroke 5. History of chronic kidney disease 6. Diabetes requiring medical treatment 7. Current smoking or history of 15 pack-years 8. History of heart failure 9. Preoperative high-sensitivity Troponin T =14ng.L-1 10. Preoperative NT-proBNP =200 pg.mL-1 Exclusion Criteria: 1. Scheduled for pheochromocytoma surgery 2. Scheduled for liver and kidney transplantation 3. Requiring preoperative intravenous vasopressor medications 4. Contraindications to epinephrine, norepinephrine or phenylephrine per clinical judgement 5. Permanent atrial fibrillation 6. Preoperative heart rate >110 bpm |
Country | Name | City | State |
---|---|---|---|
Austria | Medical University of Vienna | Vienna |
Lead Sponsor | Collaborator |
---|---|
Medical University of Vienna | Medical University of Graz |
Austria,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Tertiary Outcome 1: NT-proBNP | Maximum concentration of NT-proBNP in the first three postoperative days | Within the first three postoperative days | |
Other | Tertiary Outcome 2: Troponin T | Maximum concentration of Troponin T in the first three postoperative days | Within the first three postoperative days | |
Other | Tertiary Outcome 3: Copeptin | Maximum concentration of Copeptin in the first three postoperative days | Within the first three postoperative days | |
Other | Exploratory Outcome 1: | Incidence of MINS | Within the first three postoperative days | |
Other | Exploratory Outcome 2: | Incidence of atrial fibrillation | Through study completion, on average 7 days | |
Other | Exploratory Outcome 3: | Incidence of acute kidney injury | During hospitalization, on average 7 days | |
Other | Exploratory Outcome 4: | Incidence of myocardial infarction | During hospitalization, on average 7 days | |
Other | Exploratory Outcome 5: | Incidence of stroke | During hospitalization, on average 7 days | |
Other | Exploratory Outcome 6: | Incidence of wound related complications | During hospitalization, on average 7 days | |
Primary | Intraoperative cardiac output | Time weighted average of intraoperative cardiac output | Intraoperative | |
Secondary | Secondary Outcome 1: Intraoperative brain regional oxygen saturation | Time weighted average of intraoperative brain regional oxygen saturation | Intraoperative | |
Secondary | Secondary Outcome 2: Intraoperative tissue regional oxygen saturation | Time weighted average of intraoperative tissue regional oxygen saturation | Intraoperative |
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