Critical Illness Clinical Trial
Official title:
Perioperative Fluid Management in Patients Receiving Major Abdominal Surgery - Effects of Normal Saline Versus an Acetate Buffered Balanced Infusion Solution on the Necessity of Catecholamines for Cardiocirculatory Support, a Randomized Controlled Double-blind Trial
Background Intraoperative hypotension is a common problem that significantly contributes to
perioperative mortality and morbidity. At the moment the "gold standard" for perioperative
fluid management is the so called "goal-directed therapy" that features fluid resuscitation
followed if necessary catecholamines if needed for perioperative cardiocirculatory support.
Worldwide the so called "physiological" sodium chlorid (0.9% NaCl) solution is the most
often used infusate for perioperative fluid management. Despite its widespread use
physiological saline has its major disadvantages such as the increased incidence of
metabolic acidosis. Nevertheless catecholamines have their significant side effects as well
(eg diminished renal perfusion, increased cardiovascular morbidity) and they therefore
should be used with caution.
In a prior study by group members on patients undergoing renal transplantation receiving
either physiological saline or an acetate-buffered infusate showed a 50% decrease in
catecholamine necessity in the acetate-buffered infusate group. The investigators therefore
would like to evaluate the effects of the perioperative fluid choice on the necessity of
catecholamine use.
Aim
- Evaluation of the perioperative fluid choice on the necessity of catecholamines for
cardiocirculatory support.
- Description of the relationship between perioperative fluid choice and minimal blood
pressure as well as the time to catecholamine use and their dosage.
Methods The investigators plan a prospective randomized-controlled trial of all patients
undergoing major abdominal surgery at the Vienna General Hospital and Medical University of
Vienna. Fluid management and catecholamine use will be based on a oesophageal Doppler -based
treatment scheme.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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