Effects of Intraoperative, Goal-directed Crystalloid vs. Colloid Fluid Resuscitation on Free Flaps
Effects of Intraoperative, Goal-directed Crystalloid vs. Colloid Fluid Resuscitation on Microcirculation in Free Flap Reconstruction of Intraoral Tumours.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Csongrád
-
Szeged, Csongrád, Hungary, 6725
- Department of Anaesthesiology and Intensive Therapy
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age over 18
- Tumour location: intraoral
- Free flap type: radial forearm
- Signed informed concent form
Exclusion Criteria:
- Vulnerable subject as defined in International Standards Organization 14155:2011
- End stage oral cancer
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Crystalloid group
|
Primary fluid admission: 1 mL/bodyweight kg/ hour crystalloid.
If Pulse pressure variation is lower than 10%; 250 mL/15 min of colloid or crystalloid is administered depending on randomization.
Norepinephrine is administered if Mean arterial pressure drops below 65 mmHg.
Mean arterial pressure must be maintained above 65 mmHg.
Norepinephrine is titrated accordingly.
Dobutamine is administered if Cardiac index drops below 2.5 L/min/m2.
Cardiac index must be maintained above 2.5 L/min/m2.
Dobutamine is titrated accordingly.
|
|
Active Comparator: Colloid group
|
Primary fluid admission: 1 mL/bodyweight kg/ hour crystalloid.
If Pulse pressure variation is lower than 10%; 250 mL/15 min of colloid or crystalloid is administered depending on randomization.
Norepinephrine is administered if Mean arterial pressure drops below 65 mmHg.
Mean arterial pressure must be maintained above 65 mmHg.
Norepinephrine is titrated accordingly.
Dobutamine is administered if Cardiac index drops below 2.5 L/min/m2.
Cardiac index must be maintained above 2.5 L/min/m2.
Dobutamine is titrated accordingly.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Changes of Pulse pressure variation during the operation and the post-operative 24 hours
Time Frame: 24 hours
|
24 hours
|
|
Assesment of free falp microcirculation by laser dopler flowmetry method.
Time Frame: 24 hours
|
24 hours
|
|
Total need of Norepinephrine and Dobutamine during surgery and the post-operative 24 hours.
Time Frame: 24 hours
|
24 hours
|
|
Changes of Cardiac Index during the operation and the post-operative 24 hours.
Time Frame: 24 hours
|
24 hours
|
|
Mean arterial pressure during the operation and the post-operative 24 hours.
Time Frame: 24 hours
|
24 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Length of Intensive Care Unit stay
Time Frame: 24 hours
|
24 hours
|
|
Number of surgical or non-surgical complications.
Time Frame: 24 hours
|
24 hours
|
|
Length of Hospital stay
Time Frame: 10 days
|
10 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Cecconi M, Hofer C, Teboul JL, Pettila V, Wilkman E, Molnar Z, Della Rocca G, Aldecoa C, Artigas A, Jog S, Sander M, Spies C, Lefrant JY, De Backer D; FENICE Investigators; ESICM Trial Group. Fluid challenges in intensive care: the FENICE study: A global inception cohort study. Intensive Care Med. 2015 Sep;41(9):1529-37. doi: 10.1007/s00134-015-3850-x. Epub 2015 Jul 11. Erratum In: Intensive Care Med. 2015 Sep;41(9):1737-8. multiple investigator names added.
- Salzwedel C, Puig J, Carstens A, Bein B, Molnar Z, Kiss K, Hussain A, Belda J, Kirov MY, Sakka SG, Reuter DA. Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study. Crit Care. 2013 Sep 8;17(5):R191. doi: 10.1186/cc12885.
- Holzle F, Rau A, Loeffelbein DJ, Mucke T, Kesting MR, Wolff KD. Results of monitoring fasciocutaneous, myocutaneous, osteocutaneous and perforator flaps: 4-year experience with 166 cases. Int J Oral Maxillofac Surg. 2010 Jan;39(1):21-8. doi: 10.1016/j.ijom.2009.10.012. Epub 2009 Nov 26.
- Laszlo I, Janovszky A, Lovas A, Vargan V, Oveges N, Tanczos T, Mikor A, Trasy D, Loderer Z, Piffko J, Szabo A, Molnar Z. Effects of goal-directed crystalloid vs. colloid fluid therapy on microcirculation during free flap surgery: A randomised clinical trial. Eur J Anaesthesiol. 2019 Aug;36(8):592-604. doi: 10.1097/EJA.0000000000001024.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Protective Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Cardiotonic Agents
- Adrenergic beta-Agonists
- Sympathomimetics
- Adrenergic beta-1 Receptor Agonists
- Vasoconstrictor Agents
- Norepinephrine
- Dobutamine
Other Study ID Numbers
Other Study ID Numbers
- Free Flap Microcirculation
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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