Fluid Management in Patients Undergoing Cardiac Surgery (Hemacetat)
Fluid Management in Patients Undergoing Cardiac Surgery - Effects of an Acetate Versus Lactate Buffered Balanced Infusion Solution on Hemodynamic Stability, a Randomized Controlled Double-blind Trial
Background: Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intra- and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. Despite continuing evaluation no superiority of one particular type of fluid has been reached so far. To the best of the investigators' knowledge no study in humans has ever assessed whether the type of crystalloid fluid given for fluid resuscitation in patients undergoing cardiac surgery has an impact on hemodynamic stability and cardiac function so far. Nonetheless in the animal model it was shown that the choice of crystalloid fluid may greatly influence cardiac performance
Primary Aim: In this study the investigators want to clarify whether a balanced type acetate-buffered fluid solution in patients undergoing cardiac surgery is associated with better hemodynamic stability and cardiac function than a lactate-buffered crystalloid solute.
調査の概要
状態
条件
研究の種類
入学 (実際)
段階
- フェーズ 4
連絡先と場所
研究場所
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Bern、スイス、3010
- Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Elective single heart valve replacement
- Elective double valve replacement
- Elective single or double valve replacement and coronary artery bypass grafting
Exclusion Criteria:
- Patients unable to give informed consent
- Patients younger than 18 years of age or older than 80 years
- Pregnancy or breastfeeding
- Ejection fraction (EF) of less than 30% preoperatively
- Preexisting renal insufficiency with a glomerular filtration rate below 30ml/min
- Patients transferred form the intensive care unit to the operating theater
- Emergency operation
- Reoperation
- Patients planned for fast-track surgery
- Patients planned for minimal extracorporal circuits
- Preexisting anemia requiring immediate perioperative blood transfusion
- Chronic inflammatory diseases
- Any signs of infection or sepsis
- Limitation of full therapy (e.g. Jehowa's witnesses)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:Ringer lactate
Fluid resuscitation will be performed with lactated Ringers during the perioperative period.
Perioperative hemodynamic management will be performed according to a specified treatment protocol.
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手順:perioperative hemodynamic management with vasoactive medications (norepinephrine, adrenaline ect)
Perioperative hemodynamic management will be performed according to a specified treatment protocol.
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アクティブコンパレータ:Ringer acetate
Fluid resuscitation will be performed with acetated Ringers during the perioperative period.
Perioperative hemodynamic management will be performed according to a specified treatment protocol.
|
手順:perioperative hemodynamic management with vasoactive medications (norepinephrine, adrenaline ect)
Perioperative hemodynamic management will be performed according to a specified treatment protocol.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Cumulative dose of inopressors (norepinephrine and epinephrine) per kg bodyweight/hour during the perioperative period
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Time on inopressors
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Cumulative dose of inodilators
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Time on inodilators
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Cumulative dose of vasodilatators
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Time on vasodilatators
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Total amount of fluid
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Changes in acid-base status
時間枠:Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
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協力者と研究者
捜査官
- 主任研究者:Carmen A Pfortmueller, MD、Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- 20160804.1.3
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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