Coronary Artery Disease Clinical Trial
Official title:
Predicting Fluid Responsiveness in on Pump Coronary Artery Bypass Graft Using Extra Systoles and Investigation of a Novel Mini Fluid Challenge Ability to Predict Fluid Responsiveness
The purpose of this study is to determine if extra systoles can be used to predict fluid responsiveness perioperatively in patients undergoing on pump coronary artery bypass graft (CABG) surgery. As an additional study we will investigate the ability of a mini fluid challenge to predict response of a larger volume of fluid.
From induction of anaesthesia to cardioplegia we will serve two fluid challenges. Before and
after each challenge we will collect hemodynamic data and use this to asses our two
hypotheses.
Fluid responsiveness (the outcome to predict) will be defined as a 15% increase in stroke
volume(SV) from immediately before fluid infusion is initiated (baseline) to after the full
fluid infusion. Stroke volume is derived from the gold-standard pulmonary artery catheter
measurement of cardiac output(CO), which is standard monitoring for these patients (SV =
CO/heart rate). From subsequent offline analysis of the extracted curve data we will
investigate if post-ectopic characteristics from identified extra systoles during the
baseline period can predict fluid responsiveness (i.e. the SV change). This analysis
addresses the primary hypothesis. Also, we will analyse the arterial waveform related to the
mini fluid challenge for morphologic changes (comparing heart beats before the infusion with
heart beats during the infusion) and see if such transient changes, e.g. in systolic blood
pressure, are able to predict fluid responsiveness. This analysis addresses the secondary
hypothesis.
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