Cardiac Surgery
Conditions
Keywords
end-expiratory occlusion test, end-inspiratory occlusion test, transesophageal echocardiography, passive legs raising, fluid challenge
Brief summary
The purpose of the study is to verify the efficacy of using end-expiratory and end-inspiratory occlusion tests as an index of fluid responsiveness in mechanically ventilated patients with cardiac surgery.
Detailed description
Patients with hypotension after anesthetic induction for cardiac surgery, who requires fluid resuscitation based on clinical judgement by the anesthesiologists are enrolled in this study. Patients are monitored by transesophageal echocardiography and FloTrac/Vigileo. Hemodynamic variables (heart rate, systolic blood pressure, diastolic blood pressure, mean artery pressure, central venous pressure, stroke volume variation, cardiac index, velocity time integral of the aorta etc) are measured at baseline, after end-expiratory occlusion (EEO) test, after end-inspiratory occlusion (EIO) test, after passive legs raising test, and after fluid challenge respectively. Responders are defined by an increase in velocity time integral over 15% after infusion of 5ml/kg of crystalloid solution.
Interventions
DIAGNOSTIC_TESTEEO and EIO test
velocity time integral of the aorta measured by transesophageal echocardiography after end-expiratory and end-inspiratory occlusion test
Sponsors
Shanghai Zhongshan Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* cardiac surgical patients * hypotension after induction of anesthesia * required volume expansion by clinical judgement of the anesthesiologist
Exclusion criteria
* younger than 18 years * severe valve regurgitation or systolic dysfunction of the right ventricle * contraindication of the transesophageal echocardiography examination * cardiac arrhythmia * left ventricular ejection fraction less than 30% before surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| responders | within 1 minute after volume expansion | responders are defined by volume time integral increases over 15% after volume expansion of 5ml/kg crystalloid |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| nonresponders | within 1 minute after volume expansion | nonresponders are defined by volume time integral increases less than 15% after volume expansion of 5ml/kg crystalloid |
Countries
China
Contacts
Primary ContactZhe Luo, PhD
Outcome results
None listed