Fluid Therapy, Microcirculation
Conditions
Keywords
minimally invasive coronary artery bypass grafting, fuid therapy, microcirculation
Brief summary
Through preoperative fluid therapy, to investigate whether it can alleviate the microcirculation dysfunction after induction of anesthesia, and reduce the incidence of perioperative fluid therapy-related complications, thereby accelerating rehabilitation.
Detailed description
Patients undergoing minimally invasive coronary artery bypass graft surgery were randomly divided into crystal group, colloid group and control group. The preoperative fluid reactivity was evaluated according to the passive leg lifting test (PLR). When stroke volume increased (△SV)\>16%, the patients in the crystal (carbonate Ringer solution) and the colloid group (hydroxyethyl starch solution) were treated with volume therapy, while the control group was not treated with PLR test and volume therapy. Vascular occlusion test was used to observe the effect of anesthesia induction on tissue oxygen saturation recovery slope (RecStO2) after volume therapy, Goal-directed fluid therapy was used during operation, and the postoperative microcirculation function and the incidence of related complications were observed.
Interventions
OTHERcrystal therapy
Infusion of 250ml crystal solution before anesthesia induction
OTHERcolloid therapy
Infusion of 250ml colloid solution before anesthesia induction
Sponsors
Beijing Anzhen Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years old * Plan to undergo elective minimally invasive coronary artery bypass grafting (left anterior descending branch); * Sign informed consent
Exclusion criteria
* Left ventricular ejection fraction \<40% * Diabetes * Renal insufficiency (serum creatinine\>177umol/L) * Liver insufficiency (AST, ALT\>3 times) * Peripheral vascular disease * Carotid artery stenosis (\>60%) VOT test contraindications (arm deformity, burns, arteriovenous shunt) * Use glucocorticoids, vasoactive drugs, inotropic drugs or intra-aortic balloon counterpulsation (IABP) * Allergic to colloidal fluids
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in DesStO2 is assessed | The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | DesStO2(%/min):The downhill slope of StO2 reflects the oxygen consumption rate |
| Change in tM is assessed | The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | The time for minimum value of StO2 to recover to maximum value of StO2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | up to 60 days | — |
| Duration of stay in the intensive care unit | up to 60 days | — |
| Change in mean arterial pressure is assessed | 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | — |
| Change in SDC-1 is assessed | 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | SDC-1(ng/ml): As a valuable clinical biomarker for glycocalyx degradation |
| Change in HS is assessed | 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | HS(ng/ml): As a valuable clinical biomarker for glycocalyx degradation |
| Change in heart rate is assessed | 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation | — |
Contacts
Primary ContactBoqun Cui, Doctor
Outcome results
None listed