Cut-Off Value, Excision, Fluid Therapy, Intraoperative, Plethysmographic Variability Index, Serum Lactate, Supra-Tentorial Brain Tumors
Conditions
Brief summary
This study aimed to compare two cut-off values of plethysmographic variability index (PVI) -guided fluid therapy in patients undergoing supra-tentorial mass excision regarding immediate postoperative serum lactate.
Detailed description
Fluid therapy in patients undergoing craniotomy is very critical; hypovolemia might decrease cerebral perfusion, while fluid overinfusion might cause brain swelling that impairs surgical removal of lesions. The plethysmographic variability index (PVI) is one of the dynamic indices of fluid responsiveness, a simple, automatic, non-invasive, and continuous method based on calculating changes in the perfusion index (PI).
Interventions
OTHERFluid Therapy
Patients would receive the second round of fluid loading if the Plethysmographic Variability Index (PVI) was 14%.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age above 18 years old. * Both sexes. * Patients scheduled for supra-tentorial brain tumor excision.
Exclusion criteria
* Arrhythmias. * Pulmonary hypertension. * Impaired cardiac contractility. * Impaired liver or kidney function. * Low lung compliance. * Body mass index above 40. * Intra-operative hemodynamic instability on vasopressors or inotropes. * Peripheral arterial occlusive diseases. * Hand injuries or burns that preclude the application of the Masimo device probe.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum lactate level | 24 hours postoperatively | Serum lactate level was measured at the end of surgery (immediately after extubation). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Brain Relaxation scale | Intraoperatively | The neurosurgeon assessed the Brain Relaxation scale at three time intervals: with dural opening, after two hours, and before dural closure. A 4-point scale will be performed as follows: grade 1, perfectly relaxed; grade 2, satisfactorily relaxed; grade 3, firm brain; grade 4, bulging brain. |
| Heart rate | 20 minutes after fluid loading | Heart rate was measured immediately after fluid loading and every 5 minutes for 20 minutes. |
| Mean arterial pressure | 20 minutes after fluid loading | Mean arterial pressure was measured immediately after fluid loading and every 5 minutes for 20 minutes. |
| Length of hospital stay | Till discharge from the hospital (Up to 2 weeks) | Length of hospital stay was recorded from admission till discharge from the hospital. |
Countries
Egypt
Outcome results
None listed