Pulse Pressure Variation Measured During Valsalva Maneuver to Predict Fluid Responsiveness Under Open-chest Condition

Pulse Pressure Variation Measured During Valsalva Maneuver to Predict Fluid Responsiveness Under Open-chest Condition in the Patients Undergoing Off-pump Coronary Arterial Bypass Grafting

Pulse pressure variation (PPV) is a well-known dynamic preload indicator to predict fluid responsiveness. However, its usefulness in open-chest conditions has been equivocal. The investigators evaluated whether PPV measured during Valsalva maneuver can predict fluid responsiveness after sternotomy.

Study Overview

• Status: Completed
• Conditions: Sternotomy; Cardiac Surgical Procedures; Thoracic Surgical Procedures
• Intervention / Treatment: Procedure: Valsalva maneuver; Other: Fluid loading

• Study Type: Observational
• Enrollment (Actual): 55

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 135-710
    • Samsung Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 80 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Adult patients undergoing elective off-pump coroanry arterial bypass grafting

Description

Inclusion Criteria:

- Adult patients undergoing elective off-pump coronary arterial bypass grafting

Exclusion Criteria:

• Preoperative LV EF <= 35%
• Moderate or severe valvular heart disease
• Cardiac arrhythmia
• Intracardiac shunt
• Severe renal or liver disease
• Moderate to severe pulmonary hypertension (mean PAP > 35 mmHg)
• Patients with bullous lung disease or combined pneumothorax

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Valsalva maneuver; This is an observational study and as a diagnostic intervention, subjects in the study would receive valsalva maneuver. Valsalva maneuver was performed after sternotomy with the constant airway pressure of 30cmH2O for 2 breaths duration. The investigators perform this procedure to every patients and do not assign this intervention to the subjects of the study.	Procedure: Valsalva maneuver; Valsalva maneuver was performed after sternotomy with the constant airway pressure of 30cmH2O for 2 breaths duration.; Other Names: Lung recruitment maneuver; Other: Fluid loading; We record the cardiac index values before and after volume expansion with 6ml/kg of balanced crystalloid; Other Names: Balanced crystalloid infusion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Pulse pressure variation during Valsalva maneuver	during Valsalva maneuver

Secondary Outcome Measures

Outcome Measure	Time Frame
Pulse pressure variation after sternotomy	5 min after sternotomy

Collaborators and Investigators

• Sponsor: Samsung Medical Center

Publications and helpful links

General Publications

• Min JJ, Kim TK, Lee JH, Park J, Cho HS, Kim WS, Lee YT. Evaluation of augmented pulse pressure variation using the Valsalva manoeuvre as a predictor of fluid responsiveness under open-chest conditions: A prospective observational study. Eur J Anaesthesiol. 2017 May;34(5):254-261. doi: 10.1097/EJA.0000000000000613.

Study record dates

Study Major Dates

• Study Start: October 1, 2014
• Primary Completion (ACTUAL): May 1, 2015
• Study Completion (ACTUAL): May 1, 2015

Study Registration Dates

• First Submitted: April 22, 2015
• First Submitted That Met QC Criteria: May 26, 2015
• First Posted (ESTIMATE): May 29, 2015

Study Record Updates

• Last Update Posted (ESTIMATE): September 14, 2015
• Last Update Submitted That Met QC Criteria: September 11, 2015
• Last Verified: September 1, 2015

More Information

Terms related to this study

• Other Study ID Numbers: SMC 2014-07-005