- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03779373
Assisted Fluid Management in Patients Undergoing Major Abdominal and Orthopedic Surgery (AFM)
Manual Versus Assisted Fluid Management in Patients Undergoing Major Abdominal and Orthopedic Surgery: A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Many trials have indicated that goal-directed fluid therapy (GDFT) strategies may benefit high-risk surgical patients but these strategies are infrequently implemented. It has also been shown that without any goal or protocol for fluid resuscitation, large inter- and intra-provider variability exist and have been correlated with marked variations in patient outcomes. Even under ideal study conditions, strict adherence to GDFT protocols is hampered by the workload and concentration required for consistent implementation.Haemodynamic monitors and protocols alone do not enable optimal fluid titration to be provided consistently to all patients - there must also be appropriate and timely interpretation and intervention.
To address this problem of consistency and protocol adherence, a clinical decision support system, "Assisted Fluid Management" (AFM), has been designed to help ease some of the workload associated with GDFT protocol implementation. The AFM system (released on the European market in March 2017) may help increase GDFT protocol adherence while leaving direction and guidance in the hands of the care providers. This system can suggest fluid bolus administration, analyse the effects of the bolus, and continually re-assess the patient for further fluid requirements.
A recent published study demonstrated that the implementation of the AFM for GDFT guidance resulted in a significantly longer period during surgery with a SVV <13% with a reduced total amount of fluid administered without any difference in postoperative complications. Therefore the goal of this randomized controlled trial is to compare a manual GDFT approach ( standard of care actually in the department) versus an Assisted fluid management approach (using the AFM mode) on the incidence of minor postoperative complications.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Kremlin Bicetre
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Paris, Kremlin Bicetre, France, 94270
- Joosten Alexandre
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All adult patients in the operating room scheduled for a major abdominal & orthopedic surgery requiring a cardiac output monitoring (EV1000).
- Written informed consent received before surgery.
Exclusion Criteria:
- Minor Patients.
- No french speaking.
- Atrial fibrillation or severe arythmia.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: EV1000 monitoring
This group of patients will receive fluid administration during surgery based on a manual GDFT protocol actually in place in the department using the EV1000 monitoring device (Edwards Lifesciences, Irvine, USA)
|
The way to administer fluid is based on the same monitoring device but will differ by the way fluid is given ( following a manual GDFT protocol versus following recommendation from an active clinical deicsion support system for fluid administration called AFM (assisted fluid management)
|
EXPERIMENTAL: EV1000 monioring with the decision (AFM)
This group of patients will receive fluid administration during surgery based on a novel clinical decision support system for GDFT guidance using the EV1000 monitoring device (Edwards Lifesciences, Irvine, USA)
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The way to administer fluid is based on the same monitoring device but will differ by the way fluid is given ( following a manual GDFT protocol versus following recommendation from an active clinical deicsion support system for fluid administration called AFM (assisted fluid management)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
composite criteria of minor postoperative complications
Time Frame: 30 days postsurgery
|
This composite score includes 8 items :
|
30 days postsurgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Time spent during the procedure with a stroke volume variation < 13%
Time Frame: Postoperative day 1
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Percentage of Time spent during the procedure with a stroke volume variation < 13%
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Postoperative day 1
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Percentage of Time spent during the procedure with a Cardiac index >2.5l/min/m2
Time Frame: Postoperative day 1
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Percentage of Time spent during the procedure with a Cardiac index >2.5l/min/m2
|
Postoperative day 1
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composite criteria of major postoperative complications
Time Frame: 30 days postsurgery
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This composite score includes 14 items :
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30 days postsurgery
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cardiac index over the procedure
Time Frame: Postoperative day 1
|
average cardiac index over the surgery
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Postoperative day 1
|
stroke volume over the procedure
Time Frame: Postoperative day 1
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average stroke volume over the procedure
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Postoperative day 1
|
stroke volume variation over the procedure
Time Frame: Postoperative day 1
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average stroke volume variation over the procedure
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Postoperative day 1
|
Total Fluid received during the procedure
Time Frame: Postoperative day 1
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amount of fluid received during surgery
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Postoperative day 1
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Net fluid balance
Time Frame: Postoperative day 1
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Net fluid balance at the end of the ICU stay
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Postoperative day 1
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Postoperative acute care unit or intensive care unit length of stay
Time Frame: 30 days postsurgery
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Postoperative acute care unit or intensive care unit length of stay
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30 days postsurgery
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Hospital length of stay
Time Frame: 30 days postsurgery
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hospital length of stay
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30 days postsurgery
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Jacques Duranteau, PhD, Bicetre Hospital
- Study Chair: APHP BICETRE, Assistance Publique - Hôpitaux de Paris
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
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
Other Study ID Numbers
- 2018-A03365-50
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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