New Methods to Detect a Decrease in Heart Function

Cardiac Output Changes During Onset of Spinal Anesthesia in Elderly Patients

The purpose of this study was to evaluate the changes in heart function during onset of spinal anesthesia using a new and less invasive method, the LidcoTMplus.

Study Overview

• Status: Completed
• Conditions: Orthopedic Surgery

Detailed Description

The incidence of hypotension during onset of spinal anesthesia in elderly patients varies from 27% to 80% depending on which definition being used. Studies of cardiac output (CO) has shown that it is maintained or only slightly decreased .

Unfortunately, the time-resolution in these studies is often several minutes, and the description of changes is consequently often a start-to-end relation rather than a description of the dynamic changes during onset of spinal anesthesia.

A recent advance in measuring CO is the LiDCOTMplus hemodynamic monitor, which has proved reliable compared to pulmonary artery catheters in various intensive care settings. This monitor allows for beat-to-beat measuring during various procedures and thus early warning of hemodynamic events.

Another method with potential for early warning of decreased perfusion is near-infrared spectroscopy (NIRS). NIRS is used for continuous and non-invasive monitoring of cerebral oxygen saturation (ScO2) and even a small reduction has recently shown to predict maternal hypotension during caesarian section.

The aim of our study was to describe the changes in CO during onset of spinal anesthesia in elderly patients using a method with high time-resolution. We also attempted to evaluate NIRS as predictor of hemodynamic events.

• Study Type: Observational
• Enrollment (Actual): 32

Contacts and Locations

Study Locations

• Denmark
  • Copenhagen, Denmark, 2100
    • Department of anaesthesia, 4231, Center of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Elderly patients undergoing spinal anaesthesia

Description

Inclusion Criteria:

• Age 60 years or older
• Elective orthopedic or plastic lower limp surgery
• in spinal anesthesia

Exclusion Criteria:

• Body weight <40 kg
• Currently in treatment with lithium
• Evidence of aortic valve regurgitation

Study Plan

How is the study designed?

Collaborators and Investigators

• Sponsor: Rigshospitalet, Denmark
• Collaborators: The Danish Medical Research Council; Oberstinde Kirsten Jensa la Cours Foundation
• Investigators: Study Chair: Lars S. Rasmussen, MD, PhD, Department of anaesthesia, 4231, Center of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2004
• Primary Completion (Actual): March 15, 2005
• Study Completion (Actual): March 15, 2005

Study Registration Dates

• First Submitted: September 12, 2005
• First Submitted That Met QC Criteria: September 12, 2005
• First Posted (Estimated): September 19, 2005

Study Record Updates

• Last Update Posted (Actual): April 4, 2025
• Last Update Submitted That Met QC Criteria: April 1, 2025
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: 22-04-0019