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.
Status | Recruiting |
Enrollment | 28 |
Est. completion date | June 22, 2020 |
Est. primary completion date | April 22, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: - Elective CABG surgery - Age greater than 18 years old and less than 80 years old - Written inform consent Exclusion Criteria: - Previous pulmonary disease or pulmonary hypertension - Previous renal replacement therapy - Left ventricular ejection fraction < 40% - Body mass index > 40 kg/m2 - Atrial fibrillation - Presence of cardiac pacemaker or another implantable electronic device - Bleeding associated to hemodynamic instability - Cardiac arrest or suspicion of neurological alteration - Hemodynamic instability (norepinephrine dose > 0.5 mcg/Kg/min) |
Country | Name | City | State |
---|---|---|---|
Brazil | Heart Institute | Sao Paulo | SP |
Lead Sponsor | Collaborator |
---|---|
Ludhmila Abrahão Hajjar | University of Sao Paulo |
Brazil,
Braun F, Proença M, Wendler A, Solà J, Lemay M, Thiran JP, Weiler N, Frerichs I, Becher T. Noninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography. J Clin Monit Comput. 2019 Oct 17. doi: 10.1 — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Difference between the variation of the stroke volume and impedance variation (mean difference in %) | Mean difference between stroke volume variation and impedance variation during different fluid responsiveness maneuvers, baseline condition and after volume infusion assessed by transpulmonary thermodilution and pulse contour method for stroke volume using VolumeView system, and electrical impedance parameters measured by Electrical impedance tomography for impedance variation | within 2 hours after patient admission in the ICU | |
Primary | Correlation between the variation of the stroke volume and impedance variation | Correlation test between the change (delta) of stroke volume and impedance variation during different fluid responsiveness maneuvers, baseline condition and after volume infusion assessed by transpulmonary thermodilution and pulse contour method for stroke volume using VolumeView system, and electrical impedance parameters measured by Electrical impedance tomography for impedance variation | within 2 hours after patient admission in the ICU | |
Secondary | Agreement between stroke volume variation (delta) (mean difference in %, CI and limits of agreement) | To evaluate the accuracy of the passive leg elevation (PLR) maneuver as a predictor of fluid responsiveness in the immediate postoperative of CABG, we will compare the variation in stroke volume before-and-after PLR and before-and-after the infusion of 500mL of Ringer lactate | within 2 hours after patient admission in the ICU | |
Secondary | Agreement between stroke volume variation (SVV) delta during PLR maneuver and with the infusion of volume | Comparison of Stroke volume variation (SVV) delta between passive leg raising and the infusion of 500mL of Ringer Lactate (mean difference in %, CI and limits of agreement) | within 2 hours after patient admission in the ICU | |
Secondary | To evaluate the ability of increment of PEEP to predict fluid responsiveness | Comparisson between change in percentage of the stroke volume measure by VolumeView, during fluid responsiveness tested by PEEP increasing, Passive leg raising, and the Gold standard, fluid infusion of 500mL of Ringer Lactate | within 2 hours after patient admission in the ICU | |
Secondary | Safety of assessment stroke volume by EIT during fluid responsiveness Test (delta of Sodium, in mEq/mL) | Mean difference in the plasmatic sodium measure before and after the protocol which include 6 injection of hypertonic saline | within 2 hours after patient admission in the ICU |
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