Anesthesia; Adverse Effect, Diastolic Dysfunction, Heart Failure, Hemodynamic Instability, Venous; Return (Anomaly)
Conditions
Keywords
hemodynamics, venous return, heart failure, anesthesia
Brief summary
The study aim is to investigate whether preoperative heart failure has impact on hemodynamic stability during anesthesia induction by target controlled infusion of anesthesia (TCI) in non-cardiac, non-morbidly obese surgery.
Detailed description
40 individuals are enrolled to the study after signed informed consent at the day of surgery. The study participants are randomized (non-blinded) to preoperative fluid therapy (preoperative colloid fluid bolus at 6 ml/kg LBW, Gelofusine™, Fresenius Kabi AB, Sweden) or control (no preoperative fluids) before standardized TCI- induction of anesthesia. No other intravenous fluids before anesthesia induction. Preoperative screening of biventricular systolic and diastolic function of the heart and level of venous return is implemented by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction.
Interventions
OTHERPreoperative colloid fluid bolus (Gelofusine)
Preoperative colloid fluid bolus
DIAGNOSTIC_TESTPreoperative transthoracic echocardiography
Screening of biventricular systolic and diastolic function of the heart and level of venous return by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction.
Sponsors
Umeå University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
A consecutive cohort. Signed informed consent is gathered. Non-blinded randomization is conducted to fluid therapy before anesthesia induction. Preoperative diagnostics by echocardiography is conducted to all participants.Two arms, with or without preoperative fluids, are studied regarding hemodynamic stability during anesthesia induction.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age over 18 years * body mass index ≤ 35 kg/m2 * electively scheduled for breast cancer surgery, endocrinologic surgery (thyroid, parathyroid) and general abdominal surgery
Exclusion criteria
* instable angina pectoris * severe bronchial asthma * severe COPD * dementia * severe heart valve disease * severe renal failure * body mass index \> 35 kg/m2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of blood pressure drops | 20 minutes post anesthesia induction | Blood pressure drop below mean arterial pressure at 65 mmHg during anesthesia induction. Non-invasive blood pressures (systolic, mean and diastolic) are measured 5 minutes before anesthesia induction and thereafter every 5 minutes post-induction . |
| Incidence of severe blood pressure drops | 20 minutes post anesthesia induction | Blood pressure drop below mean arterial pressure at 55 mmHg during anesthesia induction. Non-invasive blood pressures (systolic, mean and diastolic) are measured 5 minutes before anesthesia induction and thereafter every 5 minutes post-induction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Venous return and hemodynamic stability | 20 minutes post anesthesia induction | Level of venous return impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg |
| Systolic heart failure and hemodynamic stability | 20 minutes post anesthesia induction | Systolic heart failure impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg |
| Diastolic dysfunction and hemodynamic stability | 20 minutes post anesthesia induction | Diastolic dysfunction impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg |
Countries
Sweden
Outcome results
None listed