Diastolic Dysfunction, Stroke Volume Variation
Conditions
Brief summary
This investigator initiated, prospective, observational, single-center study is designed to assess whether dynamic monitors of cardiac function such as stroke volume variation (SVV) that have been shown to predict volume responsiveness differ in clinical utility between patients with and without diastolic dysfunction.
Detailed description
This investigator initiated, prospective, observational, single-center study is designed to assess whether dynamic monitors of cardiac function, such as stroke volume variation (SVV), that have been shown to predict volume responsiveness differ in clinical utility between patients with and without diastolic dysfunction. Specific Aims: * Determine the threshold for the predictive response of SVV with respect to increasing cardiac output for patients with and without diastolic dysfunction. * Compare the trans thoracic ultrasound assessment of left ventricular diastolic function before and after the induction of general anesthesia.
Interventions
PROCEDURETrans thoracic Ultrasound Examination
Ultrasound examination of cardiac function before and after induction of general anesthesia.
OTHERIntravenous fluid administration
Intravenous fluids will be administered as a bolus in response to standard clinical indications
Sponsors
University of California, Davis
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients Undergoing Elective surgical procedures where invasive arterial line pressure monitoring is a planned part of the intraoperative management * Age greater than or equal to 18 * Procedures requiring general anesthesia and mechanical ventilation
Exclusion criteria
* Adults unable to provide consent * Atrial Fibrillation or other significant active arrhythmia * Emergency Procedures * Hemodynamic instability requiring vasopressor and/or inotropic infusions * Presence of an intra-aortic balloon pump * Open thoracic procedures * Extremes of BMI less than 20 or greater than 40 * Pregnancy * Prisoners * Patient Refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact of diastolic function on the response threshold for stroke volume variation (SVV) as a predictor of the cardiac output response to fluid administration. | Through study completion, an average of 1 year | The sensitivity of SVV as a predictor of the change in cardiac output in response to IV fluid administration will be determined by analysis of the Receiver Operator Characteristic (ROC) curves for each of the patient groups as distinguished by their pre-induction assessment of diastolic left ventricular function |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Grade assessment of diastolic function | Through study completion, an average of 1 year | Transthoracic ultrasound will be performed before and after the induction of general anesthesia to assess left ventricular diastolic function. Measurements of trans-mitral flow velocities and tissue Doppler velocities will be used to establish the grade of left ventricular diastolic function. The reproducibility of this measurement before and after the induction of anesthesia has ramifications for intra-operative measurement of diastolic function. |
Countries
United States
Outcome results
None listed