Hip Arthroplasty Replacement
Conditions
Keywords
Blood loss, Blood volume
Brief summary
Clinical assessment of bleeding and calculation of perioperative blood loss do not provide an accurate estimate of blood volume. This makes rational fluid management difficult, which is of high importance for patient-related outcomes. The availability of carbon monoxide(CO)-rebreathing allows for simple, non-invasive and precise measurement of changes in blood volume. The purpose of the study is to investigate and describe changes in blood volume and fluid distribution perioperative in patients undergoing total hip arthroplasty. Furthermore, to investigate the association between changes in blood volume and incidence of orthostatic insufficiency.
Interventions
None listed
Sponsors
Copenhagen University Hospital, Hvidovre
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for an elective total hip arthoplasty (THA) in a standardized fast track setting. * Capable of participating in CO-rebreathing measurement * Age ≥ 18 years * Able to speak and understand Danish * Has provided written informed consent.
Exclusion criteria
* Intraoperative blood loss exceeding 750 mL. * Perioperative need for a blood transfusion. * Confirmed or suspected coagulopathies. * Factors that make CO-rebreathing measurement impossible. * Known orthostatic intolerance. * American Society of Anesthesiologists physical status (ASA) classification ≥ 4.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in total blood volume (TBV) | Preoperatively and 6 hours postoperatively | Measured in milliliter (mL) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in total blood volume (TBV) | Preoperatively and 24 hours postoperatively | measured in mL |
| Changes in total hemoglobin mass (tHgb) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Measured in gram (g) |
| Changes in erythrocyte volume (EBV) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Measured in mL |
| Changes in plasma volume (PV) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Measured in mL |
| Changes in hematokrit (Ht) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Reported as percentage(%) |
| Changes in hemoglobin (Hg) concentration | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Measured in millimoles/liter(mmol/L) |
| Changes in Total body water(TBW), intra-(ICF) and extracellular(ECF) fluid distribution | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Full body water via bioelectrical impedance analysis. The individual components are reported in L and percent. |
| Association between peripheral perfusion index and total blood loss | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Peripheral perfusion index measured in percent and total blood loss in mL |
| Association between total hemoglobin (SpHb) and total blood loss | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | SpHb measured as gram/deciliter and total blood loss measured in mL |
| Changes in C-Reactive Protein (CRP) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Measured in milligram/liter (mg/L) |
| Incidence of orthostatic intolerance during mobilization | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Symptoms of orthostatic intolerance: dizziness, nausea, vomiting, blurry vision or syncope during mobilization |
| Association between total blood loss and incidence of orthostatic intolerance | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | Blood loss measured in mL. Symptoms of orthostatic intolerance: dizziness, nausea, vomiting, blurry vision or syncope during mobilization |
| Association between changes in C-Reactive Protein and total blood loss | Preoperatively, 6 hours postoperatively and 24 hours postoperatively | C-Reactive Protein measured in mg/L and total blood loss measured in mL |
Other
| Measure | Time frame | Description |
|---|---|---|
| Intraoperativ estimation of bleeding | Intraoperative at end of the surgical procedure | Measured by weighting gauze (gram) |
| Intraoperative bleeding | Intraoperative at end of the surgical procedure | Measured by visual estimation in surgical drains (mL) |
Countries
Denmark
Contacts
Primary ContactPuk Kristiansen, MD
Backup ContactAna-Marija Hristovska, Senior registrar, Ph.D.
Outcome results
None listed