Stroke Volume Variation Clinical Trial
— HemorecrutOfficial title:
Comparison of Stroke Volume Variation During Alveolar Recruitment With Stepwise Increase in Positive End Expiratory Pressure and Continuous Positive Airway Pressure (30cmH2O During 30 Seconds) in Anesthetised Patients
During general anaesthesia, pulmonary atelectasis has been shown to occur in 85 to 90% of patient. Pulmonary atelectasis increases occurrence of postoperative pulmonary complication including pneumoniae. Pulmonary atelectasis can be prevented or reversed by alveolar recruitment manoeuvres (ARM). Two methods for ARMs have been described. A sustained continuous positive airway pressure (CPAP) or a stepwise increase in PEEP.The transient increase in intrathoracic pressure during ARMs decreases venous return and increases pulmonary vascular resistance. This result in a decrease in right and left ventricular stroke volume (SV). Finally, the deleterious hemodynamic effects of ARMs may be exacerbated by hypovolemia, heart failure, and in patients with chronic treatment wich impedes cardiovascular responses to hypovolemia. At our best knowledge, there is no study which compared the hemodynamic effects of ARM using sustained CPAP or stepwise increase in PEEP. Consequently, the present study was designed to examine the hemodynamic effects of 2 ARM methods in anesthetized patients.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | December 31, 2017 |
Est. primary completion date | December 31, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - adult patients aged 18 year and above, American Society of Anesthesiologists physical status II to IV, scheduled for intermediate and high risk abdominal and vascular surgery (as defined by the guidelines on non-cardiac surgery: cardiovascular assessment and management), and equipped with a radial arterial catheter and transoesophageal doppler monitor Exclusion Criteria: - Patients less than 18 year-old, adults under protection, pregnant women, patients with atrial fibrillation, history of right ventricular dysfunction, known left ventricular ejection fraction < 30%, or preoperative pulmonary disease |
Country | Name | City | State |
---|---|---|---|
France | CHU de Caen | Caen |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Caen |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | change in stroke volume | stroke volume measured by transoesophageal doppler probe | before and during the alveolar recruitment maneuver | |
Secondary | cardiac index | cardiac index measured by transoesophageal doppler probe | before, during, 1 and 3 min after the alveolar recruitment maneuver | |
Secondary | pulse pressure variation | pulse pressure variation displayed on the hemodynamic monitor | before, during, 1 and 3 min after the alveolar recruitment maneuver | |
Secondary | arterial pressure | arterial pressure : systolic, diastolic and mean | before, during, 1 and 3 min after the alveolar recruitment maneuver | |
Secondary | heart rate | heart rate displayed on the hemodynamic monitor | before, during, 1 and 3 min after the alveolar recruitment maneuver | |
Secondary | peak velocity | peak velocity measured by transoesophageal doppler probe | before, during, 1 and 3 min after the alveolar recruitment maneuver | |
Secondary | Corrected Flow Time | Corrected Flow Time measured by transoesophageal doppler probe | before, during, 1 and 3 min after the alveolar recruitment maneuver |
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