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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05361252
Other study ID # VGHKS16-CT8-25
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date February 1, 2017
Est. completion date December 31, 2018

Study information

Verified date June 2022
Source Kaohsiung Veterans General Hospital.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Studies have demonstrated that the rate of change in stroke volume variation (SVV) can be used to determine the volume of body fluids during major abdominal surgery. Anaesthesiologists can use SVV as a guide for the appropriate administration of intraoperative fluids to improve postoperative prognoses. Liver surgery is a major abdominal operation, and the amount of blood lost is typically higher than that during other general abdominal surgeries. Blood loss is positively correlated with the intraoperative fluid infusion volume, and greater blood loss is associated with more postoperative complications. Additionally, comorbid liver disease or cirrhosis can increase the complexity of liver tumour resection, causing difficulty in assessing intravascular volume and determining the appropriate intraoperative infusion volume.


Recruitment information / eligibility

Status Completed
Enrollment 118
Est. completion date December 31, 2018
Est. primary completion date December 31, 2018
Accepts healthy volunteers No
Gender All
Age group 20 Years to 75 Years
Eligibility Inclusion Criteria: - We initially selected 118 patients who required hepatectomy. - The physiological status of the patients was assessed in terms of American Society of Anesthesiologists scores I-III Exclusion Criteria: - Extreme body mass index (BMI) - Age under 20 or over 75 years - Emergency surgery - Preexisting cardiac, hepatic, renal, or coagulation disorder; hyperthyroidism; and sinus arrhythmia.

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
SVV-guided fluid management
fluid will be guided by value of stroke volume variation

Locations

Country Name City State
Taiwan Kaohsiung Veterans General Hospital Kaohsiung

Sponsors (1)

Lead Sponsor Collaborator
Kaohsiung Veterans General Hospital.

Country where clinical trial is conducted

Taiwan, 

References & Publications (26)

Boldt J, Ince C. The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review. Intensive Care Med. 2010 Aug;36(8):1299-308. doi: 10.1007/s00134-010-1912-7. Epub 2010 May 26. Review. Retraction in: Intensive Care Med. 2020 Jun;46(6):1301. — View Citation

Choi JM, Lee YK, Yoo H, Lee S, Kim HY, Kim YK. Relationship between Stroke Volume Variation and Blood Transfusion during Liver Transplantation. Int J Med Sci. 2016 Feb 20;13(3):235-9. doi: 10.7150/ijms.14188. eCollection 2016. — View Citation

Choi SS, Kim SH, Kim YK. Fluid management in living donor hepatectomy: Recent issues and perspectives. World J Gastroenterol. 2015 Dec 7;21(45):12757-66. doi: 10.3748/wjg.v21.i45.12757. Review. — View Citation

Correa-Gallego C, Tan KS, Arslan-Carlon V, Gonen M, Denis SC, Langdon-Embry L, Grant F, Kingham TP, DeMatteo RP, Allen PJ, D'Angelica MI, Jarnagin WR, Fischer M. Goal-Directed Fluid Therapy Using Stroke Volume Variation for Resuscitation after Low Central Venous Pressure-Assisted Liver Resection: A Randomized Clinical Trial. J Am Coll Surg. 2015 Aug;221(2):591-601. doi: 10.1016/j.jamcollsurg.2015.03.050. Epub 2015 Apr 7. — View Citation

Gan TJ, Soppitt A, Maroof M, el-Moalem H, Robertson KM, Moretti E, Dwane P, Glass PS. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology. 2002 Oct;97(4):820-6. — View Citation

Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. CMAJ. 2005 Feb 1;172(3):367-79. Review. — View Citation

Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, Corvera C, Weber S, Blumgart LH. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002 Oct;236(4):397-406; discussion 406-7. — View Citation

Lang K, Boldt J, Suttner S, Haisch G. Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery. Anesth Analg. 2001 Aug;93(2):405-9 , 3rd contents page. Retraction in: Anesth Analg. 2011 May;112(5):1211. — View Citation

Lefrant JY, Bruelle P, Aya AG, Saïssi G, Dauzat M, de La Coussaye JE, Eledjam JJ. Training is required to improve the reliability of esophageal Doppler to measure cardiac output in critically ill patients. Intensive Care Med. 1998 Apr;24(4):347-52. — View Citation

Lim C, Audureau E, Salloum C, Levesque E, Lahat E, Merle JC, Compagnon P, Dhonneur G, Feray C, Azoulay D. Acute kidney injury following hepatectomy for hepatocellular carcinoma: incidence, risk factors and prognostic value. HPB (Oxford). 2016 Jun;18(6):540-8. doi: 10.1016/j.hpb.2016.04.004. Epub 2016 May 7. — View Citation

Lopes MR, Oliveira MA, Pereira VO, Lemos IP, Auler JO Jr, Michard F. Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Crit Care. 2007;11(5):R100. — View Citation

McKendry M, McGloin H, Saberi D, Caudwell L, Brady AR, Singer M. Randomised controlled trial assessing the impact of a nurse delivered, flow monitored protocol for optimisation of circulatory status after cardiac surgery. BMJ. 2004 Jul 31;329(7460):258. Epub 2004 Jul 8. Erratum in: BMJ. 2004 Aug 21;329(7463):438. — View Citation

Moug SJ, Smith D, Wilson IS, Leen E, Horgan PG. The renal sequelae of a novel triphasic approach to blood loss reduction during hepatic resection. Eur J Surg Oncol. 2006 May;32(4):435-8. Epub 2006 Mar 7. — View Citation

Mythen MG, Webb AR. The role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction. Intensive Care Med. 1994;20(3):203-9. Review. — View Citation

Olthof PB, Huiskens J, Schulte NR, Wicherts DA, Besselink MG, Busch OR, Heger M, van Gulik TM. Postoperative peak transaminases correlate with morbidity and mortality after liver resection. HPB (Oxford). 2016 Nov;18(11):915-921. doi: 10.1016/j.hpb.2016.07.016. Epub 2016 Sep 2. — View Citation

Osman D, Ridel C, Ray P, Monnet X, Anguel N, Richard C, Teboul JL. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007 Jan;35(1):64-8. — View Citation

Peres LA, Bredt LC, Cipriani RF. Acute renal injury after partial hepatectomy. World J Hepatol. 2016 Jul 28;8(21):891-901. doi: 10.4254/wjh.v8.i21.891. Review. — View Citation

Rahbari NN, Zimmermann JB, Schmidt T, Koch M, Weigand MA, Weitz J. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg. 2009 Apr;96(4):331-41. doi: 10.1002/bjs.6552. Review. — View Citation

Saner F. Kidney failure following liver resection. Transplant Proc. 2008 May;40(4):1221-4. doi: 10.1016/j.transproceed.2008.03.068. — View Citation

Sear JW. Kidney dysfunction in the postoperative period. Br J Anaesth. 2005 Jul;95(1):20-32. Epub 2004 Nov 5. Review. — View Citation

Siu J, McCall J, Connor S. Systematic review of pathophysiological changes following hepatic resection. HPB (Oxford). 2014 May;16(5):407-21. doi: 10.1111/hpb.12164. Epub 2013 Aug 29. Review. — View Citation

Slankamenac K, Breitenstein S, Held U, Beck-Schimmer B, Puhan MA, Clavien PA. Development and validation of a prediction score for postoperative acute renal failure following liver resection. Ann Surg. 2009 Nov;250(5):720-8. doi: 10.1097/SLA.0b013e3181bdd840. — View Citation

Su NY, Huang CJ, Tsai P, Hsu YW, Hung YC, Cheng CR. Cardiac output measurement during cardiac surgery: esophageal Doppler versus pulmonary artery catheter. Acta Anaesthesiol Sin. 2002 Sep;40(3):127-33. — View Citation

Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P. Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology. 1998 Dec;89(6):1313-21. — View Citation

Wakeling HG, McFall MR, Jenkins CS, Woods WG, Miles WF, Barclay GR, Fleming SC. Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth. 2005 Nov;95(5):634-42. Epub 2005 Sep 9. — View Citation

Yu LH, Yu WL, Zhao T, Wu MC, Fu XH, Zhang YJ. Post-operative delayed elevation of ALT correlates with early death in patients with HBV-related hepatocellular carcinoma and Post-hepatectomy Liver Failure. HPB (Oxford). 2018 Apr;20(4):321-326. doi: 10.1016/j.hpb.2017.10.001. Epub 2018 Jan 17. — View Citation

* Note: There are 26 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary The incidence of postoperative complications in the two groups. calculate the incidence of postoperative complication within 30 days From day 1 to day 30 after surgery.
Secondary The differences of perioperative ALT Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative eGFR Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative creatinine Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative T.bil Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative Hb Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative arterial lactate Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The differences of perioperative albumin Calculate the difference of the perioperative physiological variables Examination report on the 1st postoperative day.
Secondary The pain scale Assessment of postoperative pain scale up to three days postoperatively
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