Fluid Overload, Cardiac Surgery, Postoperative Complications
Conditions
Brief summary
the study aims to examine the validity of combined end-expiratory and end-inspiratory occlusion test and tidal volume challenge test for prediction of fluid responsiveness in immediate post-cardiac surgery patients
Detailed description
multiple studies prove that dynamic variables based on heart-lung interactions accurately can predict fluid responsiveness in mechanically ventilated patients, including pulse pressure variation (PPV) and stroke volume (SV) variation. Furthermore, passive leg raising (PLR), end-expiratory occlusion test, and tidal volume challenge test, Mini-fluid challenge are currently available to assess fluid responsiveness.
Interventions
PROCEDURECombined end-expiratory occlusion and end-inspiratory occlusion test
The EEO test will be performed by interrupting the mechanical ventilation at end-expiration over 15 seconds using the end-expiratory hold button available on the ventilator. The EIO test will be performed by interrupting the mechanical ventilation at end-inspiration over 15 seconds using the end-inspiratory hold button available on the ventilator.
PROCEDURETidal volume challenge test
elevating tidal volume from 6 ml/kg to 8 ml/kg for only 60 seconds
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients on mechanical ventilation * Patients ≥18 years of age * patients undergoing cardiac surgery (coronary artery bypass graft, valve repair/ replacement, combined cardiac surgery) * patients with normal systolic function of the left and right ventricle * patient is mechanically ventilated with a protective lung strategy
Exclusion criteria
* Patients with Spontaneously breathing activity * Patients undergoing emergent cardiac surgery. * Patient with severe peripheral arterial occlusive disease * Pregnant women * Contraindication of passive leg raising test * unstable post-operative course * Post-operative complications such as uncontrolled bleeding, severe neurologic impairment, or accidental mechanical complications; * presence of residual severe tricuspid or any valvular regurgitations * low cardiac output, low ejection fractions (EF ≤45%) * open chest,Pao2/Fio2 ≤ 200
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The number of volume responder participants could be detected using each fluid responsiveness test | immediate postoperative period | The number of volume responder participants could be detected using each fluid responsiveness test including tidal volume challenge test and combined end-expiratory occlusion and end-inspiratory occlusion test |
Countries
Egypt
Outcome results
None listed