Assessing the impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation in patients undergoing general surgical procedures

Assessing renal blood flow, as measured by urinary oxygenation, acute kidney injury (AKI) and biomarkers of AKI (Nephrocheck) in patients undergoing Laparoscopic and Open General Surgery

Status

Completed

Phases

Phase 2

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12623000726651

Enrollment

Registered

2023-07-05

Start date

2020-10-19

Completion date

2022-10-05

Last updated

2025-09-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

The impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation (PuO2), a validated surrogate of renal medullary PO2, during general surgery is unclear. We aimed to assess the effects of different blood pressure targets and surgical procedures on PuO2. In this pilot, single centre, randomised controlled physiological study, patients were allocated to usual mean arterial pressure target management or a slightly higher mean arterial blood pressure target as managed by the treating anesthetists during the operation. The primary outcome was the mean urinary oxygen value during the operation. In doing so, our trial has explored the complex relationship between blood pressure targets, surgical procedures, and renal oxygenation and guide future investigations aiming to personalise renal protective perioperative management stratagies.

Interventions

Mean arterial blood pressure target to be within 10% of the patient's pre-operative baseline or above 75 mmHg, whichever was the greater number and to be targeted by the anaesthesiology team using noradreanline and metaraminol vasopressor drugs at doses they deem clinically necessary achieve the targeted blood pressure number after induction and for the duration of the surgical procedure.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Blinded (masking used) (Outcomes Assessor)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Adult patients aged equal to or greater than 18 years of age. Schedule to have either a laparoscopic or open general surgery Require placement of a urinary catheter as a part of routine clinical care Participant provides own consent

Exclusion criteria

Baseline serum creatinine greater than 200µmol.L-1 or an estimated glomerular filtration rate according to the CKD-EPI method below 30ml.min-1.1.73m-2 Patients with acute kidney injury as defined by the KDIGO consensus criteria, pregnant women Pre-anaesthetics mean arterial pressure greater than 100mmHg or lower than 65mmHg

Outcome results