- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03184272
Non-invasive Assessment of Cardiac Output and Fluid Responsiveness in Bariatric Surgery
Accuracy of Non-invasive Assessment of Cardiac Output and Fluid Responsiveness in Patients Undergoing Bariatric Procedures.
Study Overview
Status
Conditions
Intervention / Treatment
- Procedure: baseline alert 1
- Procedure: Anti-Trendelenburg-position (ATB)
- Procedure: ATB in narcosis
- Procedure: baseline in narcosis 1
- Procedure: passive leg raising
- Procedure: volume bolus substitution
- Procedure: baseline in narcosis 2
- Procedure: start capnoperitoneum
- Procedure: ATB plus capnoperitoneum
- Procedure: ATB plus capnoperitoneum plus volume bolus substitution
- Procedure: ATB loss of capnoperitoneum
- Procedure: baseline
- Procedure: baseline alert 2
- Procedure: torso position rising 30° at the beginning
- Procedure: torso position rising 30° at the end
Detailed Description
Comparability of discontinuous non-invasive (sphygomanometric) and continuous semi-invasive and invasive (Masimo©; Nexfin© Monitoring ; FloTrac © Edwards Lifesciences) beat to beat measurement methods for the determination of cardiac output and fluid responsiveness in patients undergoing bariatric surgery.
Bariatric patients show limitations regarding the conventional monitoring options with ECG derivation, pulse oxymetric oxygen saturation and sphygmo-manometric blood pressure measurement. From a clinical point of view this results in an invasive arterial blood pressure monitoring. In addition to that, intraoperative extreme changes of the patients position on the table combined with the applied pneumoperitoneum during the minimally invasive laparoscopic surgery can significantly influence the cardiovascular parameters. An invasive arterial blood pressure monitoring is able to reproduce the blood pressure by stroke, but it does not give any information about the cardiac output. The sphygmomanometric blood pressure measurement also entails the risk of insufficient detection of a hypotonic phase in the measurement. Additional monitoring systems are currently available, which are capable of measuring completely non-invasive or semi-invasively different cardiovascular parameters such as cardiac output (CO) and volume responsiveness. In this study, the investigators will compare continuous and discontinuous cardiovascular monitoring procedures and their parameters. The measurements take place at specific times, under defined changes in the body position with the additional influence of the pneumoperitoneum.
These changes are recorded and compared at the same time during different measuring methods preoperatively, intraoperatively and postoperatively. The non-invasive Nexfin © Monitoring (Edwards Lifesciences) is to be evaluated and compared with further measurement methods (FloTrac © (Edwards Lifesciences)) as well as the sphygmomanometric upper arm blood pressure measurement. The investigators also compare the non-invasive and invasive continuous beat to beat blood pressure measurement with conventional, discontinuous sphygomanometric upper arm blood pressure measurement.
The planned study is the comparison of 3 different hemodynamic monitoring procedures. For the evaluation we use the method used by Bland and Altmann for calculating the mean deviation (bias) and the precision (mean value ± 2 standard deviations. In the case of multiple measurements , the modification of the Bland-Altman method is applied (repeated measurements). The number of cases was determined with n = 60 patients, followed by an intermediate evaluation. For a Bland-Altman analysis, the width w of the confidence interval for the Limits of Agreement is calculated as w = 6.79 • σ • 1 / √n, where n is number of cases and σ is the standard deviation. For a case count of n = 60, the result is w = 0.88 • σ and thus for this explorative study a sufficiently large number. In case of the dynamic variables, the percentage matching and the calculation of the kappa index are also used for the statistical evaluation.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Deutschland (DEU)
-
Kiel, Deutschland (DEU), Germany, 24105
- Universitätsklinikum Schleswig-Holstein Campus Kiel - Klinik für Anästhesiologie und Operative Intensivmedizin
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Indication for bariatric surgery was made
- Classification according to the American Society of Anesthesiologists (ASA) 2-4
- Age > 18 years
- Elective laparoscopic surgery
- Written declaration of consent
- Body Mass Index > 30 kg / m²
Exclusion Criteria:
- atrial fibrillation
- cardiac arrhythmias
- aortic aneurysm > 4,5 cm
- Peripheral arterial occlusive desease grade 3-4
- age < 18 years
- missing or incorrect patient consent form
- cognitive or linguistic barriers
Study Plan
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: bariatric surgery
baseline alert 1; Anti-Trendelenburg-position (ATB); Anti-Trendelenburg-position (ATB) in narcosis; baseline in narcosis 1; passive leg raising; volume bolus substitution (15 ml/kgKG Sterofundin balanced solution); baseline in narcosis 2; start capnoperitoneum; Anti-Trendelenburg-position (ATB) plus capnoperitoneum; ATB plus capnoperitoneum plus volume bolus substitution (15 ml/kgKG Sterofundin balanced solution); ATB loss of capnoperitoneum; baseline in narcosis; baseline alert 2; torso position rising 30° at the beginning; torso position rising 30° at the end
|
measurement in supine position
Other Names:
measurement under ATB
Other Names:
measurement under ATB in narcosis
Other Names:
measurement in supine position in narcosis
Other Names:
measurement under passive leg raising
Other Names:
measurement in supine position after volume bolus (15 ml/kgKG Sterofundin balanced solution intravenous)
Other Names:
measurement in supine position
Other Names:
measurement in supine position
Other Names:
measurement under ATB plus capnoperitoneum
Other Names:
measurement in ATB plus capnoperitoneum after volume bolus (15 ml/kgKG Sterofundin balanced solution intravenous)
Other Names:
measurement under ATB
Other Names:
measurement in supine position
Other Names:
measurement in supine position
Other Names:
measurement in the recovery unit
Other Names:
measurement in the recovery unit
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Non-invasive cardiac output, i.e. stroke volume measurement using Nexfin technology
Time Frame: From the beginning of surgery to admission to the PACU, approximately 4 hours
|
Accuracy of non-invasive assessment of cardiac output, i.e. stroke volume index in comparison to an invasive standard using FloTrac Vigileo technology
|
From the beginning of surgery to admission to the PACU, approximately 4 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Non-invasive assessment of fluid responsiveness using Nexfin technology
Time Frame: From the beginning of surgery to admission to the PACU, approximately 4 hours
|
Accuracy of non-invasive assessment of fluid responsiveness (PPV, SVV) in comparison to an invasive standard using FloTrac Vigileo technology
|
From the beginning of surgery to admission to the PACU, approximately 4 hours
|
Collaborators and Investigators
Publications and helpful links
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 (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- IN-BAR-01
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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