- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03707054
Vasopressin in Intraabdominal Pressure Elevation
Correlation Between Vasopressin and Renal Function Following a Controlled Intraabdominal Pressure Elevation
Study Overview
Status
Intervention / Treatment
Detailed Description
Increase in intraabdominal pressure (IAP) has been demonstrated to correlate with consequential hemodynamic effects. Several studies have been carried out mostly in experimental settings to define the underlying mechanisms that regulate the pathophysiology following an increase in IAP. In the last years this topic has become concerning because of the wide spread of laparoscopy, that is namely an iatrogenic acute increase in IAP.
Patients selected and consented for elective surgery will undergo standard of care and additional measurements during and after surgery. The measurements will be done at different stages of laparoscopic surgery.
- A) Baseline, patient under general anesthesia, Foley catheter positioned, beginning urine collection, before insufflation of pneumoperitoneum
- B) 10-15 minutes after insufflation of pneumoperitoneum at 15mmHg, PEEP at 5cmH2O or lowest setting
- C) 10-15 minutes after stabilization of PEEP at 10cmH2O, pneumoperitoneum still at 15 mmHg
- D) 10-15 minutes after desufflation of pneumoperitoneum and basal mechanical ventilation
Measurements include :
- Intraabdominal pressure IAP: assessed via laparoscopic insufflator, set at 15 mmHg as a standard value for all laparoscopic procedures
- Intrathoracic pressure: indirectly measured by variability of peak expiratory pressures
- Urine collection: through a Foley catheter from the beginning of surgery to post-operative day 1
- Urine osmolality (to be assessed at set time-points )
- Hourly urine output (at least 24 hours in order to evaluate expected significant variation even after the procedure end, since renal adaptation could take longer period)
- Serum/plasma collection : blood draws to evaluate specific values of
- Plasma Vasopressin (ADH)
- Serum osmolality
- Mean arterial pressure : standard of care
- Pulmonary expiratory end-pressure (PEEP): anesthesiologists routinely adapt PEEP in order to maintain an optimal ventilation, especially in obese patients and during laparoscopy
- Optic nerve sheath diameter (ONSD): a 7.5-MHz linear ultrasound probe to measure the diameter of the optic nerve sheath 3 mm behind the globe is going to be used; a trained study personnel physician will take the non-invasive sonographic picture using ultrasound. The ONSD will be measured from the captured picture. Study personnel will record the interaction on the patient's chart and include the measurement on the database
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Florida
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Weston, Florida, United States, 33331
- Cleveland Clinic Florida
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18-72
- Patients meeting NIH criteria for bariatric surgery
- Patients undergoing laparoscopic sleeve gastrectomy
Exclusion Criteria:
• Age below 18 years
- American Society of Anesthesiologist (ASA) class IV or V
- Other evident/diagnosed causes of increased IAP or increased intrathoracic pressure, except for obesity
- Active urinary tract infection
- Previous or concomitant neurological disease
- Previous or concomitant ophthalmic conditions/eye surgery
- Previous or concomitant lung diseases
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Study Arm
Measurements of optic nerve diameter, Urine and plasma osmolality, Serum vasopressin.
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Measurements of optic nerve diameter, serum and urine osmolarity, serum vasopressin
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Physiologic variations secondary to pneumoperitoneum
Time Frame: 24 hours
|
The investigators will measure the intrabdominal pressure (IAP) pressure using the laparoscopic insufflator dial, the optic nerve sheath diameter (OSND) using an ultrasound which is a surrogate of the intracranial pressure (ICP), the variation of vasopressin levels, and the urine osmolality at baseline and during pneumoperitoneum.
This is done in an effort to understand the compensatory measure used during pneumoperitoneum and abdominal compartment syndrome
|
24 hours
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- FLA 17-031
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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