Fluid Responsiveness, Gray Zone, Neurological Diseases or Conditions, Non Invasive Cardiac Output Monitoring
Conditions
Keywords
Neurosurgical patients, Fluid loading, Fluid responsiveness, NICOM, Stroke volume variation, Pulse pressure variation, Total peripheral resistance, Gray zone approach
Brief summary
Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on chest wall. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.
Detailed description
Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Many reports have focussed on evaluation of fluid responsiveness using various parameters such as pulse pressure variation (PPV) or stroke volume variation (SSV) derived from invasive or semi-invasive monitoring. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on thorax. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.
Interventions
OTHER500ml fluid loading
Fluid loading to evaluate fluid responsiveness
Sponsors
Samsung Medical Center
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* ASA I or ASA II patients aged 20-80 undergoing neurosurgery in supine position
Exclusion criteria
* Pre-existing arrythmic disorders * Congestive heart failure required medical treatment * Preoperative Creatinine 1.3mg/dl * observing self respiration during the study interventions * Bleeding tendency * Severe brain edema
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stroke volume variation | 5min following the end of rapid fluid infusion | 5min following the end of rapid fluid infusion: 5 min after the end of fluid loading |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation with pulse pressure variation | 5 min following the end of rapid fluid infusion | 5min following the end of rapid fluid infusion: 5 min after the end of fluid loading |
Other
| Measure | Time frame | Description |
|---|---|---|
| TPR(total peripheral resistance), TPRI(total peripheral resistance index) | 5min following the end of rapid fluid infusion | 5min following the end of rapid fluid infusion: 5 min after the end of fluid loading |
Countries
South Korea
Outcome results
None listed