blood flow measurements non-invasive cardiac output monitoring
Conditions
Interventions
None listed
Sponsors
Academisch Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - Adult patient (age > 18 years) - Elective open GI surgery - ASA 1-2 - Invasive arterial blood pressure monitoring - Informed consent
Exclusion criteria
Exclusion criteria: - Known significant occlusion, recent intra-arterial intervention or abnormal anatomy of aortic, femoral, carotid or brachial artery - Cerebrovascular accident - Atrial fibrillation or supraventricular tachycardias - COPD stage 3-4 - Lobectomy / pneumectomy - Active pneumonia - Cardiac failure - Severe heart valve regurgitation or stenosis (grade 3+) - Not able to measure brachial or carotid artery blood flow during surgery - Contra-indications for femoral arterial catheter placement (e.g., vascular graft)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Femoral, carotid and brachial ultrasound determined blood flow, intermittent transpulmonary thermodilution cardiac output and stroke volume determined by pulse-contour analysis (invasive and non-invasive) right before induction and under anaesthesia. When a change in preload is anticipated (e.g. a fluid bolus, start of vasopressors, and Trendelenburg position), before and after this preload change measurements will be performed. | — |
Secondary
| Measure | Time frame |
|---|---|
| The accuracy of brachial, femoral and carotid blood flow measurement with ultrasound compared to (1) intermittent transpulmonary thermodilution cardiac output measurement, (2) pulse-contour cardiac output measurement, (3) non-invasive cardiac output measurement and (4) the pooled cardiac output measurement of the mean of all the devices at each point. The variability of values due to random errors of brachial, femoral and carotid blood flow measurement with ultrasound compared to (1) intermittent transpulmonary thermodilution cardiac output measurement, (2) pulse-contour cardiac output measurement, (3) non-invasive cardiac output measurement and (4) the pooled cardiac output measurement of the mean of all the devices at each point. The bias of brachial, femoral and carotid blood flow measurement with ultrasound compared to (1) intermittent transpulmonary thermodilution cardiac output measurement, (2) pulse-contour cardiac output measurement, (3) non-invasive cardiac output measurement and (4) the pooled cardiac output measurement of the mean of all the devices at each point. The response to therapy (directional changes) of brachial, femoral and carotid blood flow measurement with ultrasound compared to (1) intermittent transpulmonary thermodilution cardiac output measurement, (2) pulse-contour cardiac output measurement, (3) non-invasive cardiac output measurement and (4) the pooled cardiac output measurement of the mean of all the devices at each point. | — |
Countries
Netherlands
Outcome results
None listed