Coronary Artery Bypass Grafting Clinical Trial
Official title:
Comparison of Dynamic Fluid Responsiveness Assessed by Electrical Impedance Tomography and Transpulmonary Thermodilution in Postoperative of Coronary Artery Bypass Grafting Patients
The purpose of this study is to evaluate the stroke volume variation measured by both methods: transpulmonary thermodilution and electrical impedance tomography (EIT), during fluid responsiveness maneuvers and after fluid replacement in the immediate postoperative of coronary artery bypass grafting (CABG) patients. Patients will be hemodinamically monitored with the VolumeView set in combination with EV1000 clinical platform and the display of valuable volumetric parameters (Edwards Lifesciences, California, USA). Simultaneoulsy, patients will be monitored with Enlight Electrical Impedance Tomography (Timpel, São Paulo, Brazil). Hemodynamic data will be assessed at baseline 1, one minute after the passive leg raising maneuver, after PEEP increment, and after 500 mL of Lactated Ringer's (bolus infusion). Blood gases sample will be assessed before and immediatly after the protocol.
In the ICU, immediately after CABG surgery, patients are submitted to mechanical ventilation
(volume-controlled mode with tidal volume = 8mL/Kg of PBW, PEEP = 8cmH2O and FiO2 = 60%,
respiratory rate to maintain PaCO2 = 35 - 45 mmHg); hemodynamically monitored with VolumeView
set in combination with EV1000 clinical platform and the display of volumetric parameters
(Edwards Lifesciences, California, USA). Electrical impedance tomography monitoring (Enlight,
Timpel, São Paulo, Brazil) is performed with a pair of electrodes belt attached around the
thorax at 4Th - 6Th intercostal space, and a flow sensor attached between the orotracheal
tube and the Y connector from the ventilator.
Before initiate the protocol, patients are submitted to a bolus of usual care doses of
sedation and muscular blockage (Fentanyl, Midazolam and Cisatracurium).
To assess fluid responsiveness patients will be submitted to two different maneuvers applied
in a random way: Passive Leg Raising (PLR) ant PEEP increment (PEEP). And after these
maneuvers patients will receive a bolus of 500 ml of Lactated Ringer's.
Measurements are performed one minute after each of these conditions:
- Baseline: before both fluid responsiveness maneuvers, before and after Lactated Ringer
infusion, patient is positioned in 450 semi-recumbent position;
- PLR: Fluid responsiveness maneuver which patient is positioned from 450 semi-recumbent
position to dorsal decubitus and the legs are raised at 450;
- PEEP increment: Fluid responsiveness maneuver which consisted in increased the PEEP
level 5 cmH2O above the mean airway pressure, patient is positioned in 450
semi-recumbent position
- Infusion of 500 mL of Ringer's; 450 semi-recumbent position.
Transpulmonary Thermodilution assessment are performed by the injection of 3 cold salines in
bolus - the injection volume varied from 10 - 20mL according to the patient's actual weight
and EIT assessment are performed by 1 injection of 10 mL of hypertonic saline at 7.5 - 10%
according to the patient's actual weight.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04566497 -
Assessment of Adverse Outcome in Asymptomatic Patients With Prior Coronary Revascularization Who Have a Systematic Stress Testing Strategy Or a Non-testing Strategy During Long-term Follow-up.
|
N/A | |
Completed |
NCT01850082 -
Randomized Endo-Vein Graft Prospective
|
N/A | |
Not yet recruiting |
NCT04657835 -
Assessment of Atrial Cardiomyopathy Using MRI as a Predictor of Cardiac Post-Operative Atrial Fibrillation After Cardiac Surgery.
|
N/A | |
Completed |
NCT02889562 -
Apixaban Versus Warfarin for the Management of Post-operative Atrial Fibrillation
|
Phase 2/Phase 3 | |
Completed |
NCT01528514 -
Effects of CUrcuminoids on Coronary Artery byPass graftIng-related myocarDial Infarction Study
|
N/A | |
Completed |
NCT01378221 -
VItamin D Metabolism in SEnescent Cardiac Surgery Patients
|
N/A | |
Completed |
NCT00848796 -
Comparative Study of Two Brands of Heparin Already on the Market
|
N/A | |
Not yet recruiting |
NCT05552586 -
Melatonin Impact on the Outcomes of Myocardial Ischemia/Reperfusion Injury During Coronary Artery Bypass Grafting Surgery
|
N/A | |
Completed |
NCT00246740 -
Protection of the Heart With Doxycycline During Coronary Artery Bypass Grafting
|
Phase 2 | |
Completed |
NCT00420667 -
Low Molecular Weight Heparin vs Unfractionated Heparin at Cardiac Surgery
|
N/A | |
Recruiting |
NCT04197700 -
The PRESSURE CABG Cardiac Surgery Trial
|
N/A | |
Not yet recruiting |
NCT05835167 -
Complete Revascularization Via Inferior Part-sternotomy
|
N/A | |
Not yet recruiting |
NCT06326996 -
Thiamine Intervention and Coronary Artery Bypass Grafting
|
N/A | |
Not yet recruiting |
NCT02732574 -
Oscillating Positive Expiratory Pressure (OPEP) Therapy in High Risk Patients Following Cardiac Surgery
|
N/A | |
Completed |
NCT01182688 -
Prospective Review of Procalcitonin After Cardiac Surgery
|
N/A | |
Completed |
NCT00903604 -
Pharmacokinetics of AP214 Acetate in Patients Undergoing Cardiac Surgery
|
Phase 2 | |
Completed |
NCT02737215 -
Prevention of Atrial Fibrillation After Coronary Artery Bypass Grafting in Patients With Obstructive Sleep Apnea
|
N/A | |
Recruiting |
NCT03209414 -
Frailty Syndrome in Daily Practice of Interventional Cardiology Ward
|
||
Recruiting |
NCT05441358 -
Assessment of Platelet Function in Patients Undergoing Open Heart Surgery
|
||
Recruiting |
NCT02400125 -
China Cardiovascular Surgery Registry
|
N/A |