Dynamic Preload Indicators in Sitting Position

N/ACompletedNCT02000570

Hospices Civils de Lyon31 enrolled

Overview

Intraoperative optimization of cardiac output using goal directed fluid challenge is associated with better outcome. Dynamic preload dependence indicators are well validated during surgery in supine position. Positioning from supine to sitting position under anesthesia is responsible of several hemodynamic changes. Predictability and cut-off values of dynamic preload dependence indicators during surgery in sitting position are unknown. The objective of this prospective study is to evaluate ability of three dynamic preload dependence indicators, i.e. PPV (Pulse Pressure Variation), SVV (Stroke Volume Variation) and PVI (Plethysmographic Variability Index), during neurosurgery in sitting position.

The primary objective is to determine PPV, SVV and PVI thresholds for which patients respond to fluid challenge in sitting position. The secondary objectives are to determine variations of PPV, SVV and PVI measures before and after positioning in sitting position, and to compare these values to each other.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Neurosurgery in Sitting Position

Interventions

Outcomes

Primary Outcomes

PPV (Pulse pressure variation)

PPV is derived from arterial pressure waveforms and is displayed in real -time on Intellivue MP70 Philips monitors. Value will be recorded before fluid challenge. Responders will be assessed by esophageal Doppler.

Time frame: 3 minutes before and after fluid challenge in sitting position

SVV (Stroke volume variation)

SVV is derived from arterial pressure waveforms and is displayed in real -time on Vigileo Edwards Lifesciences monitors. Value will be recorded before fluid challenge. Responders will be assessed by esophageal Doppler.

Time frame: 3 minutes before and after positioning in sitting position

PVI (Plethysmographic variability index)

PVI is derived from plethysmography waveforms and is displayed in real-time on Radical 7 Masimo monitors. Value of each indicator will be recorded before fluid challenge. Responders will be assessed by esophageal Doppler.