- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT02288767
The Effect of Fluid Management by SVV of FloTrac/ Vigileo™ Monitoring on Postoperative Recovery in Bowel Resection
12 september 2017 uppdaterad av: Yonsei University
During an enterectomy, especially in an open surgery, large amounts of fluid are administered in consideration of the patient's fasted state, maintaining blood pressure during surgery and potential third space loss.
However, it has recently been reported that excessive fluid administration during surgery is actually detrimental to patients' prognoses.
In fact, several reports have suggested that compared to limited fluid administration, excessive fluid administration increased the length of stay or the chances of complications.
Thus, goal-directed fluid optimization is required during surgery because only a proper amount of fluid (neither limited nor excessive) administration can minimize postoperative complications and enhance prognosis.
In general, the amount of fluid administered is determined with regard to the patient's volume status, including a comprehensive assessment of vital signs such as the pulse rate and blood pressure, and urine volume.
However, this method has limitations in that it is an inadequate indicator of the actual intravascular volume of a patient to determine and administer the proper amount of fluid.
Recently, new methods of measuring volume status that are less invasive and more accurate have been introduced.
These methods include stroke volume variation (SVV) that monitors changes in arterial pressure waveform amplitudes with regard to breathing patterns.
This is an effective method of monitoring fluid responsiveness after placing a catheter via a radial artery puncture.
The stroke output is dependent on the preload, afterload, and cardiac contractility.
The cardiac output is determined by multiplying the stroke output and heart rate.
SVV indicates the difference in stroke output within one breathing cycle.
A direct or indirect measurement of stroke output is required, which can be performed by analyzing arterial pressure waveforms via a FloTrac Sensor (Edwards Lifesciences, USA) monitor.
SVV is known to have a high fluid responsiveness even during open surgeries, yet there is practically no research data on its effect in patients' postoperative recovery and prognosis in comparison to the traditional methods of fluid administration.
Therefore, the investigators will apply SVV via a FloTrac/ Vigileo™ monitor on patients undergoing bowel resection to determine whether it better assists proper fluid administration compared to the traditional method of fluid administration by examining the patients' postoperative prognosis such as bowel movement recovery and length of stay.
Studieöversikt
Status
Avslutad
Betingelser
Studietyp
Interventionell
Inskrivning (Faktisk)
62
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Seoul, Korea, Republiken av, 120-752
- Yonsei University, College of Medicine, Yonsei Health System, Yonsei Cancer Center
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
20 år till 70 år (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Ja
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- Patients aged 20 to 70 scheduled to undergo bowel resection open surgery below the ASA class 3
Exclusion Criteria:
- Patients with significant impairments in heart, kidney, and liver functions
- Patients with arrhythmia such as tachycardia and atrial fibrillation or patients on pacemakers
- Patients diagnosed with peripheral arterial disease or are Allen's test positive
- Patients who underwent surgery on the identical surgical area
- Patients with obesity
- Patients with blood coagulation impairments
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Övrig
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Aktiv komparator: Control group
For the traditional method group, crystalloid and colloid (maximum 50 ml/kg) are provided through the traditional method of assessing the blood pressure, heart rate and urine volume.
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Experimentell: SVV group
The method of fluid administration to be employed (traditional or SVV via a FloTrac/ EV1000™ monitor) is determined based on the group.
Fluid administration is performed in accordance with the group; in general, about 10 ml/kg/h is administered although it may vary for each patient depending on the preoperative fasting, fluid loss during surgery (evaporation, emanation, urination, surgical area, etc.), and blood loss.
Crystalloid is administered in the SVV-monitored group with a target below SVV 12%, and a 200-300 ml of colloid (maximum 50 ml/kg) is loaded when SVV is above 12%.
If the patient shows hypertension even when SVV is below 12%, a vasoconstrictor should be administered intermittently or consistently.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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Recovery of bowel movement - gas passing time after bowel resection
Tidsram: 24 hous
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To evaluate the difference in bowel movement recovery whether using SVV or not on the fluid management in the patients undergoing open enterectomy, the difference of postoperative gas passing time will be compared.
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24 hous
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Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Sponsor
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Faktisk)
9 mars 2015
Primärt slutförande (Faktisk)
15 augusti 2017
Avslutad studie (Faktisk)
15 augusti 2017
Studieregistreringsdatum
Först inskickad
3 november 2014
Först inskickad som uppfyllde QC-kriterierna
6 november 2014
Första postat (Uppskatta)
11 november 2014
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
13 september 2017
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
12 september 2017
Senast verifierad
1 september 2017
Mer information
Termer relaterade till denna studie
Andra studie-ID-nummer
- 4-2014-0730
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
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