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PRO STRESS Trial: Proactive Low-Dose Norepinephrine to Reduce Intraoperative Fluid Administration in Patients at High-Risk for Postoperative Pulmonary Complications Undergoing Laparoscopic Abdominal Surgery (PRO STRESS)

2026年7月10日 更新者：Suez Canal University

Proactive Low-Dose Norepinephrine to Reduce Intraoperative Fluid Administration in Patients at High-Risk for Postoperative Pulmonary Complications Undergoing Laparoscopic Abdominal Surgery: A Randomized Controlled Trial

Intraoperative hypotension is commonly treated with fluid administration; however, excessive fluid therapy may contribute to postoperative pulmonary complications. This randomized double-blind controlled trial evaluates whether proactive administration of fixed low-dose norepinephrine reduces intraoperative crystalloid administration while maintaining hemodynamic stability in high-risk patients undergoing laparoscopic abdominal surgery. One hundred and thirty patients will be randomized to receive either norepinephrine infusion (0.03 µg/kg/min) or placebo from induction until skin closure within a protocolized hemodynamic strategy guided by mean arterial pressure and pulse pressure variation.

研究概览

地位

尚未招聘

条件

干预/治疗

研究类型

介入性

注册 (估计的)

130

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 埃及
    • Ismailia Governorate
      • Ismailia、Ismailia Governorate、埃及、41522
        • Suez Canal University hospitals
        • 接触：
        • 首席研究员：
          • Muhammad Elhossieny Salama, MD
        • 副研究员：
          • Mahmoud Hosny Ahmed, MD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

Inclusion Criteria:

  • Adult patients aged 18 years or older.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Scheduled for elective laparoscopic major abdominal surgery under general anesthesia with an expected duration greater than 2 hours.
  • Patients with ARISCAT score ≥ 45 indicating high risk for postoperative pulmonary complications.

Exclusion Criteria:

  • Known hypersensitivity to norepinephrine.
  • Severe left ventricular dysfunction with ejection fraction < 35%.
  • Significant cardiac arrhythmia.
  • Uncontrolled hypertension defined as systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg.
  • End-stage renal disease.
  • Requirement for vasopressor support before induction of anesthesia.
  • Emergency surgery.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：四人间

武器和干预

参与者组/臂
干预/治疗
实验性的：Norepinephrine Group
Participants will receive continuous norepinephrine infusion at a fixed dose of 0.03 µg/kg/min initiated immediately after induction of anesthesia and continued until skin closure within a protocolized hemodynamic management strategy.
药品：Norepinephrine
Continuous norepinephrine infusion administered at a fixed dose of 0.03 µg/kg/min from induction of anesthesia until skin closure.
安慰剂比较：Control Group
Participants will receive an equivalent volume normal saline infusion initiated immediately after induction of anesthesia and continued until skin closure within the same protocolized hemodynamic management strategy.
其他：Placebo
Equivalent volume normal saline infusion administered from induction of anesthesia until skin closure at the same infusion rate as the active intervention to maintain blinding within a protocolized hemodynamic management strategy.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Total intraoperative crystalloid administration
大体时间：From induction of anesthesia until skin closure (intraoperative period)
Total volume of crystalloid administered intraoperatively from induction of anesthesia until skin closure, measured in milliliters.
From induction of anesthesia until skin closure (intraoperative period)

次要结果测量

结果测量
措施说明
大体时间
Lactate Levels
大体时间：After induction of anesthesia, at the end of surgery, and 24 hours postoperatively
Arterial lactate concentration measured in mmol/L serially during the perioperative period
After induction of anesthesia, at the end of surgery, and 24 hours postoperatively
Urine Output
大体时间：From induction of anesthesia until skin closure (Intraoperative period)
Hourly intraoperative urine output measured from urinary catheter collection and expressed as total mL/kg/hour.
From induction of anesthesia until skin closure (Intraoperative period)
Intraoperative Blood Loss
大体时间：From surgical incision until skin closure (Intraoperative period)
Estimated intraoperative blood loss measured in milliliters using suction canister volume after subtraction of irrigation fluids in addition to surgical field assessment.
From surgical incision until skin closure (Intraoperative period)
Number of Participants with Postoperative Pulmonary Complications
大体时间：Within seven postoperative days
Incidence of postoperative pulmonary complications defined according to European Perioperative Clinical Outcome (EPCO) criteria using clinical, radiological, and laboratory findings
Within seven postoperative days
Number of Participants With Acute Kidney Injury
大体时间：Within seven postoperative days
Incidence of acute kidney injury defined according to KDIGO criteria based on serum creatinine changes and urine output.
Within seven postoperative days
Duration of Rescue Norepinephrine Requirement
大体时间：From induction of anesthesia until skin closure (Intraoperative period)
Cumulative duration of rescue open-label norepinephrine infusion for persistent hemodynamic instability measured in minutes.
From induction of anesthesia until skin closure (Intraoperative period)
Duration of Intraoperative Hypotension
大体时间：From induction of anesthesia until skin closure (Intraoperative period)
Cumulative duration of intraoperative hypotension defined as mean arterial pressure below 65 mmHg, measured in minutes using nvasive arterial blood pressure monitoring.
From induction of anesthesia until skin closure (Intraoperative period)
Number of Participants Admitted to the Intensive Care Unit
大体时间：Within seven postoperative days
Number of participants requiring admission to the intensive care unit during the postoperative period.
Within seven postoperative days
Duration of Postoperative Hospital Stay
大体时间：Within seven postoperative days
Total postoperative hospital stay measured in days during the first seven postoperative days
Within seven postoperative days
Number of Participants With Postoperative Surgical Complications
大体时间：Within seven postoperative days
Incidence of postoperative surgical complications assessed according to Clavien-Dindo classification grade II or higher during the first seven postoperative days.
Within seven postoperative days

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Suez Canal University

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年7月15日

初级完成 (估计的)

2026年10月1日

研究完成 (估计的)

2026年11月1日

研究注册日期

首次提交

2026年5月31日

首先提交符合 QC 标准的

2026年5月31日

首次发布 (实际的)

2026年6月4日

研究记录更新

最后更新发布 (实际的)

2026年7月13日

上次提交的符合 QC 标准的更新

2026年7月10日

最后验证

2026年7月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 6476# (注册表标识符：Research Ethics Committee, Faculty of Medicine, Suez Canal University)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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