- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01473446
Traditional Versus Goal Directed Perioperative Fluid Therapy in High Risk Patients
Traditional Versus Goal Directed Perioperative Fluid Therapy in High Risk Patients. A Randomized, Assessor-blinded Study
Is goal directed fluid therapy reducing postoperative complications in comparison to traditional fluid therapy for gastro surgical ASA III/IV patients?
The investigators compare two groups of patients: one group receives goal directed fluid therapy guided by LiDCOrapid stroke volume variation (SVV), the other gets the "traditional" fluids, ie the current regime.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Adult ASA class III & IV (high risk) patients
- >18 years
- scheduled for gastrointestinal surgery involving laparotomy
- Both elective and emergency cases
Exclusion Criteria:
- Atrial fibrillation
- Mental impairment, unable to give informed consent
- Severe aortic or mitral stenosis
- Type of surgery: Liver surgery, transthoracic oesophagectomy
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Ingen indgriben: Control
Standard monitoring.
Initial optimization of fluid status is performed by pulse, BP and anaesthesiologist assessment with Ringer acetate.
Followed by an infusion of 10ml/kg/t Ringer acetate.
Urinary output and blood pressure is used as a surrogate parameter: the infusion rate is increased by a fall in blood pressure or urine output <0.5ml/kg/t.
Bleeding replaced with HES 1:1, otherwise see table for fluid therapy page 9. Vasoactive agents (noradrenaline / phenylephrine) is given if the anesthesiologist considers this necessary.
Postoperative give 1000ml Glucose 5%.
HES or Ringer when low blood pressure, eventually noradrenaline as vasoactive agent.
|
|
|
Eksperimentel: Goal directed fluid therapy
|
Standard monitoring. The patient is connected to the LiDCOrapid monitor via an arterial line placed in a.radialis. A bolus of 500 ml Ringer acetate is given before anesthesia. If the stroke volume (SV) increases more than 10%, repeat the procedure until the SV is not increasing. After that, induction of anesthesia. Maintenance fluid is given as Ringer acetate 2ml/kg/t. Continuous monitoring of stroke volume variation (SVV). If SVV> 10%, give a fluid bolus 6ml/kg Ringer acetate. Repeat until SVV <10%. Bleeding is being replaced 1:1 with hydroxyethyl starch. SAG by bleeding >1000ml. By fall in blood pressure and SVV <10%, start vasoactive treatment with epinephrine. Postoperative is given Glucose 5% 80ml/h. |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Postoperative complications
Tidsramme: 5 days after surgery
|
5 days after surgery
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Length of hospital stay
Tidsramme: 3 month after surgery
|
3 month after surgery
|
|
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Complications until discharge and readmission within 30 days
Tidsramme: 3 month after surgery
|
3 month after surgery
|
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Mortality within 30 days and 3-month after surgery
Tidsramme: 3 month after surgery
|
3 month after surgery
|
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Renal function
Tidsramme: 5 days after surgery
|
defined by RIFLE criteria
|
5 days after surgery
|
|
Vasoactive agents need
Tidsramme: 3 month after surgery
|
Difference in the number of patients in need of vasoactive agents, during surgery and in the postoperative period.
|
3 month after surgery
|
Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studiestol: Ib Jammer, MD, Helse Bergen HF, Norway
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 2011/947/REK Vest
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Kliniske forsøg med Goal directed fluid therapy guided by LiDCOrapid
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Gabriele Baldini, MD, MSc, Assistant ProfessorAfsluttet