Hemodynamic Instability Clinical Trial
Official title:
Postoperative Continuous Non-invasive Haemodynamic Monitoring on the Ward: a Feasibility Study
The patient's clinical care will not be altered apart from an the use of a non-invasive
monitor for a short time, without any biological sample acquisition, or follow-up. This is
low risk.
The device works through a complex pressure measurement in the fingers and by slightly
squashing the fingers it can cause minor impairments to circulation. This represents a very
small risk. To mitigate this risk the investigators will exclude patients with impaired
circulation to the fingers and fingers will be monitored.
The approach is necessarily on the day of surgery and for many people this is an anxious
time. The investigators have a lot of experience of approaching patients on the day of
surgery for providing consent for observational studies - the investigators use caution and
sensitivity. The investigators do not approach patients who the clinical team consider
anxious or where there is significant pressure on time.
Enrolled patients will have the CNAP sited in the post-anaesthetic care unit (PACU) and it
will stay on their arm until at least 12 hours have passed. The device will collect
continuous heart rate, blood pressure, and nominal cardiac output; it also derives a range of
values from these measurements. There is minimal risk attributable to the use of the CNAP
device. These devices are already in routine clinical use in the UK in intensive care units,
high-dependency units and operating theatres.
To reduce burden on the patient, no additional HR/BP monitor is required and whenever the
usual care team would like to know the HR or BP these values will be displayed. The
additional parameters (related to measurement of cardiac output) will not be shared with the
clinical team - they will remain blinded to these data because otherwise there is the risk
that they would use this additional information to alter clinical management.
Medical notes will be examined to provide information about demographics, physical
characteristics (height, weight), and previous medical history - please see case report form
(CRF, appendix 1) for more details.
There are no blood tests, or other acquisition of biological samples.
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