A Gray Zone Approach to Stroke Volume Variation Derived From NICOM

Samsung Medical Center

Overview

Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on chest wall. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.

Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Many reports have focussed on evaluation of fluid responsiveness using various parameters such as pulse pressure variation (PPV) or stroke volume variation (SSV) derived from invasive or semi-invasive monitoring. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on thorax. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.

Study Type

OBSERVATIONAL

Conditions

Neurological Diseases or Conditions Fluid Responsiveness Non Invasive Cardiac Output Monitoring Gray Zone

Interventions

500ml fluid loadingOTHER

Fluid loading to evaluate fluid responsiveness

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA I or ASA II patients aged 20-80 undergoing neurosurgery in supine position Exclusion Criteria: * Pre-existing arrythmic disorders * Congestive heart failure required medical treatment * Preoperative Creatinine 1.3mg/dl * observing self respiration during the study interventions * Bleeding tendency * Severe brain edema

Locations (1)

Samsung medical center

Seoul, South Korea

Outcomes

Primary Outcomes

Stroke volume variation

5min following the end of rapid fluid infusion: 5 min after the end of fluid loading

Time frame: 5min following the end of rapid fluid infusion

Secondary Outcomes

Correlation with pulse pressure variation

5min following the end of rapid fluid infusion: 5 min after the end of fluid loading

Time frame: 5 min following the end of rapid fluid infusion

Data from ClinicalTrials.gov

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