Cardiac Complication
Conditions
Keywords
Cardiac surgery
Brief summary
The aim of the study is to compare end expiratory occlusion test to passive leg raising test for prediction of fluid responsiveness in post cardiac surgery mechanically ventilated patients.
Detailed description
Circulatory hypervolemia and hypovolemia are both associated with worse outcomes.Intravenous fluids are similar to drugs, with serious adverse effects and changeful efficacy. Fluids should be administered only if indicated. Passive leg raising test transiently increase venous return which can be used to evaluate fluid responsiveness.There is growing evidence that the End expiratory occlusion (EEO) test reliably detects fluid responsiveness. In patients under mechanical ventilation, the inspiration increases intra-thoracic pressure and decreases venous return. The expiratory hold augments the cardiac preload which, in case of preload responsiveness, leads to a significant increase of cardiac output (CO).EEO prevents any variation in intra-thoracic pressure leading to an increase in venous return, cardiac preload and stroke volume in preload-responsive patients. There're no studies comparing EEO with passive leg raising test in cardiac surgery patients. So, this is the target of the study.
Interventions
DIAGNOSTIC_TESTEnd Expiratory Occlusion Test
All studied mechanically ventilated patients under post operative sedation. EEO test will be applied to predict probable responder and probable non-responder according to pulse pressure variation in accordance to previous study where the response to volume expansion was defined as an increase in pulse pressure of 5% or more
DIAGNOSTIC_TESTPassive Leg Raising Test
All studied mechanically ventilated patients under post operative sedation.Passive leg raising test will be applied to predict probable responder and probable non-responder according to the PPV in accordance to previous study where the response to volume expansion was defined as an increase in pulse pressure of at least 10%
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SCREENING
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Age group: 21-60years old * Sex: eligible both sexes * Post cardiac surgery * Sedated intubated mechanically ventilated patients (Controlled ventilation with no respiratory effort)
Exclusion criteria
* Patients refusal * Pregnancy or any medical condition that may affect the intra abdominal pressure. * Lower limb deep venous thrombosis Open chest conditions impaired left-ventricular ejection fraction (\<45%), arrhythmias, inter-ventricular shunt, severe peripheral arterial occlusive disease and the need for intra-aortic balloon counter pulsation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Predictive value of EEO and passive leg raising | One year | Predictive value of EEO and passive leg raising to fluid responsiveness in post cardiac surgery mechanically ventilated patients Pulse pressure variation before and after passive leg raising test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Arterial blood pressure | One year | Effect of EEO and passive leg raising to fluid responsiveness on arterial blood pressure in post cardiac surgery mechanically ventilated patients |
| Heart rate | One year | Effect of EEO and passive leg raising to fluid responsiveness on heart rate in post cardiac surgery mechanically ventilated patients |
Other
| Measure | Time frame | Description |
|---|---|---|
| Central venous pressure | One year | Effect of EEO and passive leg raising to fluid responsiveness on central venous pressure in post cardiac surgery mechanically ventilated patients |
Countries
Egypt
Outcome results
None listed