Abdominal Tumor, Abdominal Infection
Conditions
Keywords
Tumor, Abdominal infection, Hemodynamics, Pcv-aCO2, Early Goal-directed Therapy (EGDT)
Brief summary
This research will confirm that Pcv-aCO2 is suitable for the guidance of early fluid therapy and the evaluation of the prognosis of patients with abnormal hemodynamics after abdominal tumor surgery, and is expected to be a new monitoring index to improve the therapeutic effect of these patients.
Detailed description
1. Confirmed that Pcv-aCO2 is suitable for the guidance of early fluid therapy and the evaluation of the prognosis of patients with abnormal hemodynamics after abdominal tumor surgery, and is expected to be a new monitoring index to improve the therapeutic efficacy of this kind of patients. 2. Pcv-aCO2 effectively reflected the improvement of tissue and organ microcirculation disorder through the individual goal target treatment to guide the fluid resuscitation in the hemodynamic instability patients. 3. Research of the correlation between Pcv-aCO2 and the organ function in patients with abnormal hemodynamics after operation.
Interventions
OTHERstandardized fluid therapy
The patients with ScvO2 \<70% will receive the standardized fluid therapy for 6 hours.
The patients with ScvO2 ≥ 70% will receive the conventional fluid therapy.
Sponsors
Tianjin Medical University Cancer Institute and Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
1. Acute physiology and chronic health score system II (APACHE II) score ≥10； 2. Hemodynamic abnormalities post-operation (a. systolic blood pressure\<90mmHg, or descent by basic blood pressure for more than 40mmHg. b. pulse pressure \<20mmHg, c. urine volume \<0.5ml/Kg/hr, d. heart rate \>100 / min, e.Central Venous Pressure(CVP) \<5mmHg, f. blood lactic acid \>2.7mmol/L, meet any one above). 3. Age ≥ 18 years, which is expected to stay in ICU for 5 days or longer; 4. Patients themselves or their authorized clients agree to participate in clinical trials and signed informed consent.
Exclusion criteria
1. age \<18 years; 2. without improvement in respiratory system disease or chronic obstructive pulmonary disease with Forced expiratory volume in one second (FEV1) \<50%; 3. lobectomy and pneumonectomy; 4. death within 24 after treatment; 5. patients with severe organ dysfunction; 6. pregnant or lactating women; 7. the patients did not sign informed consent; 8. any factors that may be expected to increase the risk of patients or other factors that may interfere with the results of clinical trials.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The change of Pcv-aCO2 | fluid resuscitation for 6 hours, 12 hours and 24 hours | The change of Pcv-aCO2 (mmHg) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The hospitalization course in different groups | Twenty-eighth days after admission | Collect the index of hospitalization course(days) of patients in different groups. |
| The treatment success rate in different groups | Twenty-eighth days after admission | Collect the index of treatment success rate(%) of patients in different groups. |
| The 28 day mortality in different groups | Twenty-eighth days after admission | Collect the index of 28 day mortality(%) of patients in different groups. |
Other
| Measure | Time frame | Description |
|---|---|---|
| The Oxygen Supply status (DO2) in different groups | fluid resuscitation for 6 hours, 12 hours and 24 hours | Collect the index of oxygen supply (DO2, ml/(min•m\^2)) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
| The change of Central Venous Oxygen Saturation (ScvO2) | fluid resuscitation for 6 hours, 12 hours and 24 hours | The change of Central venous oxygen saturation (ScvO2, %)after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
| The Oxygen Consumption (VO2) in different groups | fluid resuscitation for 6 hours, 12 hours and 24 hours | Collect the index of oxygen consumption (VO2, ml/(min•m\^2)) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
| The change of hemoglobin (Hb) | fluid resuscitation for 6 hours, 12 hours and 24 hours | The change of hemoglobin (Hb, g/L) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
| The change of blood lactic acid (Lac) | fluid resuscitation for 6 hours, 12 hours and 24 hours | The change of blood lactic acid (Lac, mmol/L) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
| The change of Cardiac Index (CI) | fluid resuscitation for 6 hours, 12 hours and 24 hours | The change of Cardiac Index (CI, L/(min•m\^2)) after fluid resuscitation for 6 hours, 12 hours and 24 hours respectively. |
Countries
China
Contacts
Primary ContactYang Yang, physician
Backup ContactYang Lu, physician
Outcome results
None listed