Improving outcomes in high-risk surgical patients Surgery
Conditions
Interventions
1. All patients enrolled in the study will receive standard anaesthetic care: after induction of anaesthesia with a hypnotic drug (propofol or thiopental) all patients will receive a balanced anaesthe
Sponsors
James Cook University Hospital (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Elective major open abdominal surgery (gastrointestinal, urological, gynaecological or vascular procedures with an expected duration of at least 90 minutes) 2. Requirement for invasive haemodynamic monitoring including arterial and central venous blood pressure and CO measurement 3. More than 50 years of age and at least one of the following: 3.1. Renal impairment (serum creatinine > 130 µmol/l) 3.2. Diabetes mellitus 3.3. Aged 65 years and over 3.4. Presence of a risk factor for cardiac or respiratory disease: 3.4.1. Exercise tolerance = 6 metabolic equivalents (MET?s) 3.4.2. Anaerobic threshold = 14 ml/kg/min 3.4.3. Past medical history of ischaemic heart disease 3.4.4. Heart failure 3.4.5. Moderate or severe valvular disease 3.4.6. Chronic obstructive pulmonary disease (COPD) 3.4.7. Radiographically confirmed chronic lung disease (COPD, fibrosis)
Exclusion criteria
Exclusion criteria: 1. No consent 2. Pregnancy 3. Emergency surgery 4. Vascular surgery involving aortic cross clamping 5. Allergy to Gelofusin® and Volulyte® 6. Laparoscopic surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The correlation between changes of stroke volume and hence cardiac output with changes in central venous saturation and central venous arterial partial pressure of carbon dioxide difference, respectively | — |
Secondary
| Measure | Time frame |
|---|---|
| Sensitivity and specificity of pulse pressure and stroke volume variation and pleth variability index (PVI) to predict an increase of cardiac output by at least 10% | — |
Countries
United Kingdom
Outcome results
None listed