Prostatic Neoplasm, Urinary Bladder Neoplasm
Conditions
Keywords
fluid responsiveness, central venous pressure, positive end-expiratory pressure, robot surgery
Brief summary
In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. The authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
Detailed description
In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. As a preload index, the predictability of central venous pressure, pulse pressure variation and stroke volume variations may be impaired due to the impaired hemodynamics that result from the effect of increased abdominal pressure and decreased venous return. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. Therefore, the authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
Interventions
PROCEDUREFluid loading of volulyte 300 ml
Administration of volulyte 300 ml and measurement of increase in cardiac index
Sponsors
Seoul National University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient undergoing robot-assisted laparoscopic radical prostatectomy or cystectomy. * American Society of Anesthesiologist Physical Status Classification of 1, 2 or 3.
Exclusion criteria
* Medical history of arrhythmia or new-onset arrhythmia after anesthesia induction. * Valvular or ischemic heart disease or left ventricular ejection fraction less than 40%. * Any significant pulmonary disease or history of chronic obstructive pulmonary disease * End-stage renal disease or preoperative creatinine \> 1.4 mg/dl
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| fluid responsiveness | 5 minutes after administration of 300 ml volulyte | fluid responsiveness is determined when increase in cardiac index is more than 10% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| cardiac index | one hour after the initiation of pneumoperitoneum | T1: baseline measurement of cardiac index with positive end-expiratory pressure of zero |
| stroke volume variation | one hour after the initiation of pneumoperitoneum | T1: baseline measurement of stroke volume variation with positive end-expiratory pressure of zero |
| central venous pressure | one hour after the initiation of pneumoperitoneum | T1: baseline measurement of central venous pressure with positive end-expiratory pressure of zero |
| arterial oxygen partial pressure (mmHg) | 5 minutes after anesthesia induction | arterial blood gas analysis |
| arterial carbon dioxide partial pressure (mmHg) | 5 minutes after anesthesia induction | arterial blood gas analysis |
| abdominal pressure | one hour after the initiation of pneumoperitoneum | T1: baseline measurement of abdominal pressure with positive end-expiratory pressure of zero |
Countries
South Korea
Outcome results
None listed