Post-operative Complications Clinical Trial
Official title:
The Cost in Oxygen of Surgical Trauma (CO2ST) - a Feasibility Study of the Non-invasive Measurement of Oxygen Delivery and Consumption After Major Abdominal Surgery
The investigators will examine the relationship between post-operative oxygen consumption
(using non-invasive measurement technology ) and complications in patients having
contemporary major abdominal surgery. The investigators hypothesis is that major surgery may
trigger a physiological stress response that results in an increase in post-operative
metabolic demand and oxygen consumption (V̇O2) which must be met by an increased oxygen
delivery (DO2).
1. To determine the feasibility of non-invasive measurement of oxygen consumption (V̇O2)
using indirect calorimetry in a cohort of patients
2. To determine the feasibility of non-invasive measurement of oxygen delivery (DO2) in
the same cohort using non-invasive measures of cardiac output, oxygen saturation and
haemoglobin (pulse wave transit time and co-oximetry techniques)
Prospective observational study of non-invasive measurements of V̇O2 and DO2 pre-operatively
and at 8 time points in the 48 hours postoperatively in a cohort of 40 patients undergoing
elective major abdominal surgery (both open and laparoscopic) with a pre-operative
cardiopulmonary exercise testing (CPET).
As pilot work examining the relationship between post-operative oxygen consumption and
complications in patients having contemporary major abdominal surgery , the investigators
need to define and grade the severity of complications. The Post-Operative Morbidity Survey
(POMS) is a simple outcome scale designed to record the incidence of clinically important
complications - specifically complications likely to keep a patient in hospital. A POMS
score performed on Day 5 is likely to be discriminative between patients who are recovering
well, and those who are developing complications. POMS is easily performed, has good
internal validity and is predictive of a prolonged length of stay. POMS is not a simple
additive scale; however patients with POMS score of 1 or greater are highly likely to remain
in hospital, whereas those with a score of 0 are likely to be able to go home.
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Observational Model: Cohort, Time Perspective: Prospective
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