Health Condition 1: O- Medical and Surgical
Conditions
Interventions
Intervention1: Goal Directed intraoperative fluid therapy: Intraoperative intravenous fluid administration guided by pulse pressure variation obtained on the Mindray monitor every 15 minutes during th
Sponsors
Department of Anesthesiology and Intensive Care Maulana Azad Medical College
Eligibility
Inclusion criteria
Inclusion criteria: Patients falling under the American Society of Anesthesiologists(ASA) physical status classes I, II, and III undergoing elective and emergency exploratory laparotomy under general anesthesia
Exclusion criteria
Exclusion criteria: 1. Pregnant patients 2. Preexisting ischemic or valvular heart disease, heart failure, or cardiac arrhythmias 3. Chronic kidney disease 4. Preexisting coagulopathies
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative plasma lactate levelTimepoint: Postoperative plasma lactate level- 1 hour after the end of surgery | — |
Secondary
| Measure | Time frame |
|---|---|
| Intraoperative blood loss and perioperative blood transfusion requirement, estimated from the intraoperative change in hematocritTimepoint: 1. Baseline hematocrit- Preoperatively before induction of anesthesia 2. Postoperative hematocrit- 1 hour after the end of surgery;Intraoperative hemodynamic trends measured by 1. Mean arterial pressure trend during the intraoperative period 2. Number of hypotensive episodes 3. Vasopressor requirement and consumption: whether vasopressor required and if yes, the total consumption in the intraoperative period in micrograms.Timepoint: Mean arterial pressure recorded at baseline ( before induction of anesthesia) and then at 15 min intervals during the intraoperative period. Total number of hypotensive episodes and vasopressor requirement/consumption during the intraoperative period at the end of surgery;Intraoperative tissue perfusionTimepoint: 1. Baseline plasma lactate level- Preoperatively before induction of anesthesia 2. hourly plasma lactate levels measured intraoperatively;Post-operative outcomes and complications 1. Need for postoperative mechanical ventilation 2. Return of bowel motility will be assessed by time till passage of first flatus 3. Postoperative pulmonary involvement 4. Incidence of wound dehiscence, anastomotic leakage or re-exploration Timepoint: They will be assessed at the end of surgery;Postoperative pulmonary, renal, hepatic and coagulation functions 1. Pulmonary function: Change in PaO2:FiO2 ratio measured from arterial blood gas analysis 2. Renal function: Intraoperative urine output(ml), postoperative serum creatinine(mg/dl) compared to preoperative baseline, post operative fractional excretion of sodium(%) 3. Hepatic function: Postoperative transaminase levels(SGPT and SGOT in IU) compared to preoperative baseline 4. Coagulation function: Postoperative INRTimepoint: PaO2:FiO2 ratio: 1. Baseline 2. 1 hour postoperatively Intraoperative urine output: Hourly dur | — |
Countries
India
Contacts
Public ContactDr Arshi Agrawal
Maulana Azad Medical College
Outcome results
None listed