Væskeudfordring og plasmavolumen under kirurgi (FC-VE)
Sammenligning af albumin og Ringers løsning til optimering af plasmavolumen og hæmodynamik under laparoskopisk kirurgi.
A short bolus infusion of fluid, called "fluid challenge" is commonly recommended for fluid treatment during longer surgery. However a prolonged increase of the blood volume is a prerequisite to recommend the technique. The purpose with the study is to examine the plasma expanding effect of three different fluid challenge strategies (acetated Ringers 4 ml/kg body weight, albumin 5% 4 ml/kg body weight or albumin 20% 1 ml/kg body weight), using hemoglobin as a dilution indicator.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
60 patients scheduled for laparoscopic abdominal surgery, with a duration exceeding 90 minutes will be included in the study. These are randomized to three different groups (20 in each groups): The first group of patients will receive boluses of acetated Ringers 4 ml/kg body weight. The second albumin 4 ml/kg body weight and the third group albumin 20% 1 ml/kg body weight.
Hemoglobin, albumin and colloid osmotic pressure (COP) is sampled the day before surgery and in the morning directly prior to the anesthesia. Bioimpedance, urine osmolality and urine-creatinin are also measured. After induction of surgery a Cardio Q probe is inserted threw the nose into the esophagus, for circulatory measurements. Initial/baseline blood samples are taken after insufflation of carbon dioxide to the abdomen. Before every bolus of fluid and 5, (10), 15, 20, 30, 40, (50) and (60) minutes new blood samples are taken for determination of hemoglobin, albumin and COP. Artery blood gases are sampled 15 minutes after every infusion or depending on the clinical need.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
-
-
Östergötland County
-
Norrköping, Östergötland County, Sverige, 60379
- Vrinnevi Hospital
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Written consent to participate in the study
- For women: relevant contraceptive, menopausal or a negative pregnancy test.
- ASA category I to III
- Laparoscopic abdominal surgery, with a duration of at least 90 minutes.
- 18 to 85 years
Exclusion Criteria:
- Patients with known cardiac failure
- <18 or >85 years
- known allergy to albumin
- extracellular hyperhydration or hypervolemia
- kidney failure
- pregnancy or planned pregnancy
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: acetated Ringers
The circulatory effect of a bolus infusion with 4 ml/kg body weight of acetated Ringers will be studied. If cardiac output increase with 10% a second bolus will be infused and further studied. |
After insufflation of carbon dioxide during an abdominal laparoscopic procedure, the first fluid bolus is infused. Circulatory and volume effects are studied. If cardiac output increase a second bolus is infused and studied.
Andre navne:
|
|
Eksperimentel: albumin 5%
The circulatory effect of a bolus infusion with 4 ml/kg body weight of Albumin 5% will be studied. If cardiac output increases with 10% a second bolus will be infused and further studied. |
After insufflation of carbon dioxide during an abdominal laparoscopic procedure, the first bolus of fluid is infused. Circulatory and volume effects are studied. If cardiac output increases a second bolus is infused and studied.
Andre navne:
|
|
Eksperimentel: albumin 20%
The circulatory effect of a bolus infusion with 1 ml/kg body weight of Albumin 20% will be studied. If cardiac output increase with 10% a second bolus will be infused and further studied. |
After insufflation of carbon dioxide during an abdominal laparoscopic procedure, the first bolus of fluid is infused. Circulatory and volume effects are studied. If cardiac output increases a second bolus is infused and studied.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Plasma volume expansion after a fluid bolus
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Plasma volume using hemoglobin as an indicator of dilution |
60 minutes after an intravenous fluid bolus
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Fluid Balance
Tidsramme: 18 to 24 hours
|
Calculations of fluid balance |
18 to 24 hours
|
|
Stroke Volume
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Change in stroke volume, measured with Cardio Q (oesophageal Doppler monitoring (ODM)) |
60 minutes after an intravenous fluid bolus
|
|
Arterial Blood Pressure
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Mean Arterial Pressure, measured with an arterial line. |
60 minutes after an intravenous fluid bolus
|
|
Heart Rate
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Heart rate, measured with ECG and pulseoximeter. |
60 minutes after an intravenous fluid bolus
|
|
Bioimpedance
Tidsramme: 18 to 24 hours
|
Bioimpedance measures, resistance and impedance converted to volume of body fluid compartments. |
18 to 24 hours
|
|
Serum Creatinin
Tidsramme: 18 to 24 hours
|
Serum Creatinin as a measure of kidney function |
18 to 24 hours
|
|
arterial pH
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Influence of a fluid bolus on arterial blood gases |
60 minutes after an intravenous fluid bolus
|
|
arterial Base Excess
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Influence of a fluid bolus on arterial blood gases |
60 minutes after an intravenous fluid bolus
|
|
arterial serum sodium
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Influence of a fluid bolus on Sodium concentration |
60 minutes after an intravenous fluid bolus
|
|
arterial serum chloride
Tidsramme: 60 minutes after an intravenous fluid bolus
|
Influence of a fluid bolus on Chloride concentrations |
60 minutes after an intravenous fluid bolus
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Joachim Zdolsek, MD PhD, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Urogenitale neoplasmer
- Neoplasmer efter sted
- Mandlige urogenitale sygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Tarmsygdomme
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Sygdomme i fordøjelsessystemet
- Gastrointestinale sygdomme
- Intestinale neoplasmer
- Endetarmssygdomme
- Tyktarmssygdomme
- Neoplasmer
- Kolorektale neoplasmer
- Urologiske neoplasmer
- Aminosyrer, peptider og proteiner
- Proteiner
- Albuminer
- Ringer's acetat
- zidovudine 5'-monophosphate-mannose-albumin conjugate
- galactosamine-conjugated serum albumin-conjugated-(rhodamine X)20
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- FC-VE
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Individual de-identified results will be shared, when results are published.
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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