Hemodynamics
Conditions
Keywords
pediatric, thoracoscopic, cardiometry, cardiac output, hemodynamics
Brief summary
Advances in endoscopic equipment and technique have led to the use of minimally invasive thoracic surgery in an increasing number of pediatric surgical procedures. Logically, thoracoscopic surgery and anesthesia can induce significant physiologic changes,, derangements of normal respiratory physiology induced by the surgical approach and the installation of carbon dioxide into the thoracic cavity can lead to alterations of normal acid-base status. Finally, surgical procedures in the chest, surgical traction or insufflation pressures impairs venous return and/or cardiac function, especially in neonates and infants. In this study Electrical Cardiometry TM (ICON, Cardiotronic/Osypka Medical, Inc., La Jolla CA, USA) is used assess the effect of different intra-thoracic pressure (insufflation pressures 4,5 & 6 mmHg) during thoracoscopic surgeries in neonates and infants on hemodynamics using electrical velocimetry (ICON) as non-invasive monitoring technique.
Interventions
DEVICECardiotronic ICON continuous non-invasive cardiac output monitor.
cardiac index, cardiac output & stroke volume measured and recorded with every change in intrathoracic pressure.
Sponsors
Cairo University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Days to 12 Months
Healthy volunteers
No
Inclusion criteria
1. ASA physical status I-II. 2. Age neonates and infants 3. Children undergoing thoracoscopic surgery surgeries.
Exclusion criteria
1. Parents' or guardians' refusal. 2. Left lateral positioning 3. Congenital heart diseases.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in Cardiac index | measured before inflation, 1 minute after inflation of the thoracic cavity at 4 mm Hg, 5 mm Hg and 6 mm Hg and after deflation | L/min/m2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| non invasive blood pressure | from time of induction of anesthesia and every 5 minutes and after every change in intrathoracic pressure and after deflation till end of surgery | mmHg |
| heart rate | from time of induction of anesthesia and every 5 minutes and after every change in intrathoracic pressure till end of surgery | beats per minute |
| stroke volume | from time of induction of anesthesia and every 5 minutes and after every change in intrathoracic pressure till end of surgery | millilitres |
| systemic vascular resistance | from time of induction of anesthesia and every 5 minutes and after every change in intrathoracic pressure till end of surgery | dynes/seconds/cm-5 |
| cardiac output | from time of induction of anesthesia and every 5 minutes and after every change in intrathoracic pressure till end of surgery | l/min |
Countries
Egypt
Outcome results
None listed