- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03044405
Focused Assessed Echocardiography to Predict Fluid Responsiveness (fluidres)
Focused Assessed Echocardiography to Predict Fluid Responsiveness for Non-cardiac Hypotensive Spontaneously Breathing Patients After Major Abdominal Surgery
The aims of the study are:
- To evaluate the feasibility of echocardiography monitoring in postoperative unit;
- To assess diagnostic value of different focussed echocardiography parameters to define fluid responsiveness for non-cardiac hypotensive spontaneously breathing patients after major abdominal surgery.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
As there are different strategies of perioperative fluid management discussion which is the choice liberal or restrictive one occurs? Individualized infusion therapy should be the goal. The investigators hypothesize extended hemodynamic monitoring based on focused transthoracic echocardiography enable to differentiate the cause of hypotension more carefully and fluid overload will be avoided after major abdominal surgery.
The goals of the study are:
- To conduct one group of hypotensive patients after major abdominal surgery. To divide this group into responders and nonresponders after fluid challenge.
- To evaluate the feasibility of echocardiography monitoring in postoperative unit (having in mind such restrains as supine position, postoperative pain, bandages etc.)
- To compare the evaluation of fluid responsiveness by clinical signs and focused assessed echocardiography data.
- To identify the best focused echocardiography parameters for prognosis of fluid responsiveness.
- To determine if extended hemodynamic monitoring changes postoperative fluid management.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age more than 18 years old.
- Patients who sign an agreement form to participate in the study.
- Patients undergoing major abdominal surgery.
- Hypotension
Exclusion Criteria:
- Younger than 18 years old.
- Known pregnancy.
- Unconscious patients or those who do not agree to participate in the study.
- Urgent surgery.
- Normal arterial blood pressure.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Responders and non-responders
Fluid challenge of 500 ml of crystalloids over 15 minutes is given.
Positive fluid responsiveness is defined by an increase in stroke volume (SV) of at least 15% assessed by focused transthoracic echocardiography.
|
Fluid bolus of 500 ml of crystalloids is given over 15 minutes.
Positive fluid responsiveness is defined by an increase in SV of at least 15%.
Focused transthoracic echocardiography is performed to assess expansion of stroke volume after fluid challenge.
Also mitral E and A waves, left ventricle outflow tract velocity time integral (LVOT VTI) and its variability, inferior vena cava diameters during breathing cycles are measured.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
All hypotensive patients are divided into responders and non-responders according to increase of left ventricle outflow tract velocity time integral (LVOT VTI) after fluid challenge.
Time Frame: the first hour after the surgery
|
Fluid challenge - fluid bolus of 500 ml of crystalloids which is given over 15 minutes. Positive fluid responsiveness is defined by an increase in stroke volume of at least 15%. Measurements are taken before and immediately after fluid challenge. |
the first hour after the surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The frequency of fluid responsiveness defined by clinical signs and focused transthoracic echocardiography data after fluid challenge is compared.
Time Frame: the first hour after the surgery
|
Positive fluid responsiveness by clinical signs is defined as increase of arterial blood pressure more than 10mmHg after fluid challenge. Positive fluid responsiveness by focused transthoracic echocardiography data is defined as increase of LVOT VTI more than 15%. |
the first hour after the surgery
|
Mitral E wave velocity (cm/s) is compared between responders and non-responders.
Time Frame: the first hour after the surgery
|
Measurement is taken before the fluid challenge.
The most reliable parameters to predict fluid responsiveness for non-cardiac hypotensive, spontaneously breathing patients after major abdominal surgery are assessed.
The area under the curve (AUC) is defined to be clinically relevant if AUC is more than 0.7.
|
the first hour after the surgery
|
E/A ratio is compared between responders and non-responders.
Time Frame: the first hour after the surgery
|
Measurement is taken before the fluid challenge.
The most reliable parameters to predict fluid responsiveness for non-cardiac hypotensive, spontaneously breathing patients after major abdominal surgery are assessed.
The area under the curve (AUC) is defined to be clinically relevant if AUC is more than 0.7.
|
the first hour after the surgery
|
Variability of LVOT VTI (%) during breathing cycles is compared between responders and non-responders.
Time Frame: the first hour after the surgery
|
Measurement is taken before the fluid challenge.
The most reliable parameters to predict fluid responsiveness for non-cardiac hypotensive, spontaneously breathing patients after major abdominal surgery are assessed.
The area under the curve (AUC) is defined to be clinically relevant if AUC is more than 0.7.
|
the first hour after the surgery
|
Cardiac index (L/min/m2) is compared between responders and non-responders.
Time Frame: the first hour after the surgery
|
Measurement is taken before the fluid challenge.
The most reliable parameters to predict fluid responsiveness for non-cardiac hypotensive, spontaneously breathing patients after major abdominal surgery are assessed.
The area under the curve (AUC) is defined to be clinically relevant if AUC is more than 0.7.
|
the first hour after the surgery
|
Variability of inferior vena cava (%) is compared between responders and non-responders.
Time Frame: the first hour after the surgery
|
Measurement is taken before the fluid challenge.The most reliable parameters to predict fluid responsiveness for non-cardiac hypotensive, spontaneously breathing patients after major abdominal surgery are assessed.
The area under the curve (AUC) is defined to be clinically relevant if AUC is more than 0.7.
|
the first hour after the surgery
|
The planed infusion therapy before and after evaluation by focused transthoracic echocardiography is compared in responders and non-responders.
Time Frame: the first 24 hours after the surgery
|
the first 24 hours after the surgery
|
Collaborators and Investigators
Investigators
- Principal Investigator: Asta Maciuliene, M.D., Lithuanian University of Health Sciences
- Study Chair: Andrius Macas, profesor, Lithuanian University of Health Sciences
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ECHO2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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