CABG, Cardiac Surgery
Conditions
Brief summary
To study the reliablity of MSFP and stressed volume to follow volume loading and to predict fload loading responsiveness in patients after elective coronary artery bypass grafting (CABG) surgery.
Detailed description
In this study the oesophageal Doppler monitor (CardioQ+), arterial pulse wave analysis (via the CardioQ+ and Flotrac device) and central venous pressure (CVP) will be used to estimate mean systemic filling pressure (MSFP) with the inspiratory hold method. Furthermore the MSFParm will be determined using a rapid cuff inflator. From MSFP vascular compliance (Csys) and stressed volume (Vs) will be calculated. The accuracy of Vs to follow a 500 increase in volume will be studied. The accuracy of MSFP and Vs to to predict fluid loading responsiveness will be assessed in 42 patients after elective coronary artery bypass grafting (CABG) surgery. The effect of a standardised fluid loading on parameters of intrinsic contractility and afterload will be determined. The effect of fluid loading on inertia, resistance and elastance will be assessed
Interventions
DIAGNOSTIC_TESTMSFP
MSFPhold and MSFParm
Sponsors
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients 18 years and older planned for CABG
Exclusion criteria
* Contraindication for fluid loading * Pregnancy, morbid obesity * Hemodynamic instability with a mean arterial pressure (MAP) \< 55 mm Hg and/ or a cardiac index \< 1.5 L•min-1 * Severe arrhythmias * Intra-cardiac shunts * Symptomatic peripheral vascular disease * Symptomatic pulmonary disease * Significant valvular regurgitation * Poor pre-operative left or right ventricular function * Core temperature \< 36 °C * Contra-indication to the rapid cuff inflator * Contra-indication to oesophageal Doppler probe insertion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MSFPhold | Before and after fluid administration (2 minutes and 10 minutes) | Mean systemic filling pressure |
| MSFParm | Before and after fluid administration (2 minutes and 10 minutes) | Mean systemic filling pressure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stressed volume | Before and after fluid administration (2 minutes and 10 minutes) | Vs |
Other
| Measure | Time frame | Description |
|---|---|---|
| SVV | Before and after fluid administration (2 minutes and 10 minutes) | stroke volume variation |
| Vascular compliance (Csys) | Before and after fluid administration (2 minutes and 10 minutes) | Vascular compliance |
| Kinetic energy | Before and after fluid administration (2 minutes and 10 minutes) | Kinetic energy |
| CVP | Before and after fluid administration (2 minutes and 10 minutes) | central venous pressure |
| PPV | Before and after fluid administration (2 minutes and 10 minutes) | pulse pressure variation |
Countries
Netherlands
Contacts
Primary ContactDenise Veelo, MD, PhD
Backup ContactAlexander Vlaar, MD, PhD
Outcome results
None listed