View clinical trials related to Hypotension.
Filter by:QTc prolongation and premature ventricular contractions (PVCs) are common in hemodialysis (HD) patients and are associated with sudden cardiac death. It is known that higher dialysate bicarbonate is associated with more QTc prolongation during HD sessions. This study aims to assess the effects of lower (30 mEq/L) versus higher (35 mEq/L) dialysate bicarbonate in adult maintenance HD patients admitted to the hospital. The investigators will randomly assign subjects to lower versus higher dialysate bicarbonate concentrations during their hospital stay for up to a maximum of six HD sessions or until their hospital discharge.
Measurement of Whole Blood Lactate Concentrations Whole blood lactate concentrations will be measured at the time of study enrollment and at 24, 48, and 72 hours. Measurement of Plasma Renin Concentrations Serum renin concentration will be measured on blood samples drawn from arterial catheters on supine position right after inclusion. Discarded whole blood samples (waste blood samples) in EDTA tubes are prospectively collected from each patient at the time of study enrollment and at 24, 48, and 72 hours.
The purpose of this study is to access the safety of etomidate - propofol mixture vs propofol in total intravenous anesthesia during abdominal surgery.
Intraoperative hypotension is closely related to the poor prognosis of surgery. The study is focused on the effectiveness of maintaining normal peripheral perfusion index (PPI) on time-weighted average of hypotension during anesthesia.
Hypotension is a common side-effect of general anesthesia induction and is related to adverse outcomes including significantly increasing risk of one-year mortality. Even short durations of intraoperative hypotension have been associated with acute kidney injury (AKI) and myocardial injury.Half of all the patients were fluid-responsive, pointing to volume status as a significant risk factor. Ultrasound measurements of inferior vena cava (IVC) diameter with respiration, including the maximal diameter of the IVC (dIVCmax) at the end of expiration during spontaneous respiration and the collapsibility index (CI), have been recommended as rapid and noninvasive methods for estimating volume status. In attempt to prevent hypotension after spinal anesthesia induction, Ondansetron, a serotonin receptor antagonist, has been used effectively . Research Question Can preoperative IVC-US guided fluid optimization and intravenous ondansetron reduce the incidence of general anesthesia-induced hypotension in adult patients undergoing elective non-cardiac non-obstetric surgery?
Pneumatic tourniquet is usually used in orthopedic surgeries, as it helps to decrease operative bed bleeding, and thus, maintaining a clean and dry surgical field allowing easy and clear identification of the anatomical structures. Despite that advantage, after its deflation, there is a blood volume shift towards that ischemic area, which may decrease cardiac preload leading to hypotension
Septic shock is defined as sepsis with persistent hypotension requiring vasopressors to maintain mean arterial pressure (MAP)≥ 65 mmHg and a serum lactate level of > 2 mmol/L (18 mg/dL) despite sufficient volume resuscitation . Hypovolemia (both relative and absolute) and reduced vascular tone have a role in determining the severity of hypotension in septic shock
The investigators aimed to investigate the deep learning model to predict intraoperative hypotension using non-invasive monitoring parameters.
We include patient who will undergo elective surgeries such as orthopedic surgeries as fixator placement, lower extremity debridement, inguinal hernia, Urosurgery as bladder- prostate resection, hysterectomy, fibroid removal, ovarian cyct removal, plastic surgeries, and other types of surgery. The fasting durations of the included patients will be 8 hours for solids and 2 hours for clear liquids. There won't be any premedication given. The patient will be placed in a supine, neutral-head resting posture in the operating room as well as standard monitors such as a five-lead electrocardiography, pulse oximeter, and noninvasive blood pressure. An attending anesthesiologist will use a 25-gauge Quincke spinal needle to induce spinal anesthesia in the L3/4 or L4/5 vertebral interspace with the patient in the right lateral decubitus posture. Throughout the course of the trial, the attending anesthesiologist will choose the dosages of 0.5% hyperbaric bupivacaine (10 to 15 mg) and fentanyl (10 to 20 mg) 28. The patient will be placed back in the supine position without any lateral tilt once the spinal injection has been given over a period of 15 to 30 seconds. Three minutes following the spinal injection, the sensory block will be evaluated with a cold and pinprick test. The mean blood pressure will be taken every 3 minutes between the spinal injection and delivery, and every 5 minutes from the delivery until the end of the procedure. The lowest SBP measured between the spinal anesthesia injection and delivery will be determined, together with the percentage of the SBP drop from the pre-anesthetic SBP. The patient's head will be turned 308 degrees to the left. First, a 6.0 to 13.0MHz linear array transducer will be positioned vertically on the neck with the probe marker facing the patient's head. The lower edge of the thyroid cartilage will provide a long-axis B-mode picture of the right common carotid artery. The probe will then be positioned in the lumen's center, around 2 cm from where the carotid arteries split. After that, carotid artery blood flow waveforms will be preserved together with a pulsed Wave-Doppler trace of the artery's flow. The cycle time will be determined by counting the number of heartbeats at the start of the systolic upstroke using an ultrasound machine's caliper function. By taking measurements in one-tenth of millisecond intervals between the systolic upstroke and the diastolic notch, the flow time will be determined. the IVC will be scanned using a portable ultrasound device (LOGIQ-e by GE health care) and a 3.5-5 MHz curvilinear probe in the subxiphoid region (paramedian long-axis view), just close to the common hepatic vein's draining to the IVC. At the point where the IVC joins the right atrium, a 2D picture will be obtained. M-mode imaging will be used to record changes in IVC diameter during inspiration and expiration. The procedure is carried out two to three centimeters away from the right atrium/IVC junction. The attending anesthetist will keep track of how long it took to locate the IVC after placing the probe on the patient. The M mode of the ultrasonography will be used to measure the IVC's Minimum (IVCDMin) and Maximum (IVCDMax) diameters, and the IVC Collapsibility Index (IVCCI) will be calculated.
The goal of this observational study is to develop a computation model for accurately predicting post-induction hypotension in patients receiving laparoscopic surgery under general anesthesia. The main question[s] it aims to answer are: • whether the corresponding characteristics on pressure wave forms could be use to predict post-induction hypotension. Participants will be observed before and after induction of general anesthesia for non-invasive arterial pressure wave forms and blood pressure changes.