- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving 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.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
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 studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Ingen inngripen: 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.
|
|
|
Eksperimentell: 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. |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Postoperative complications
Tidsramme: 5 days after surgery
|
5 days after surgery
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Length of hospital stay
Tidsramme: 3 month after surgery
|
3 month after surgery
|
|
|
Complications until discharge and readmission within 30 days
Tidsramme: 3 month after surgery
|
3 month after surgery
|
|
|
Mortality within 30 days and 3-month after surgery
Tidsramme: 3 month after surgery
|
3 month after surgery
|
|
|
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
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Studiestol: Ib Jammer, MD, Helse Bergen HF, Norway
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 2011/947/REK Vest
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