Major Abdominal Surgery
Conditions
Keywords
Glycocalyx, Microcirculation, Cephalic DuodenoPancreatectomy, Hyperthermic Intraperitoneal Chemotherapy
Brief summary
The study of the microcirculation and glycocalyx could be an essential element in the monitoring of our patients undergoing major abdominal surgery. It would enable us to better target the objectives of anaesthesia and resuscitation, which until now have been based essentially on macro-circulatory parameters.
Detailed description
This monitoring is possible in real time and real conditions by micro-camera GlycoCheck™ (Microvascular Health Solutions Inc., Salt Lake City, Utah, USA), a non-invasive monitoring allowing the study of sublingual microcirculation and glycocalyx.
Interventions
PROCEDURECytoreduction surgery with Hyperthermic Intraperitoneal Chemotherapy
Cytoreduction surgery with Hyperthermic Intraperitoneal Chemotherapy
PROCEDURECephalic DuodenoPancreatectomy
Cephalic DuodenoPancreatectomy
Sponsors
University Hospital, Rouen
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Inclusion criteria
For the HIPEC group : * Adult patients * Age \< 75 years * Receiving HIPEC for primary or secondary peritoneal carcinosis For the CDP group : * Adult patient * Age \< 75 years * Receiving CDP for pancreatic neoplasia * Patient who has read and understood the information letter and does not object to taking part in the study * Patient affiliated to a social security scheme
Exclusion criteria
* Secondary distant peritoneal metastases * Chronic heart failure * Chronic liver failure at stage C of the Child-Pugh score * Stage IV or V chronic renal failure * Inflammation of the sublingual buccal mucosa or injury that may locally influence sublingual microcirculation * Patient refusal * Person deprived of liberty by an administrative or judicial decision or person placed under court protection or guardianship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Glycocalyx thickness | between the day before the operation (Day -1) and the post-operative period (Day 1) | Perioperative variation in glycocalyx thickness (µm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Glycocalyx thickness and a biological marker of tissue hypoperfusion | post-operative period (Day 1) | To assess, in each population ((HIPEC and CDC), the association between the thickness of the glycocalyx established by analysis of the sublingual microcirculation using GlycoCheck® and a biological marker of tissue hypoperfusion. |
| Glycocalyx thickness and a biological marker of tissue hypoxia | post-operative period (Day 1) | Establish the link between glycocalyx thickness and a biological marker of tissue hypoxia. |
| Blood cell velocity and macrocirculatory function | post-operative period (Day 1) | Assess the association between velocity of the red blood cells (µm/s) and cardiac index obtained by Most-Care® monitoring on Day 1. |
| Perfused capillary density and macrocirculatory function | post-operative period (Day 1) | Assess the association between perfused capillary density (mm/mm2) and cardiac index obtained by Most-Care® monitoring on Day 1. |
| Variation of glycocalyx thickness and the daily entry-exit balance (BES) Day 1 | between Day -1 and Day 1 | To assess the difference between water and fluid intake (perfusion, nutrition, drug dilution solution) and output (diuresis, digestive aspiration, diarrhoea) over 24 hours |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORZoé DEMAILLY, Dr
University Rouen Hospital
Outcome results
None listed