The aim of the study is to identify the diagnostic value of the focused assessed echocardiography in septic patients undergoing urgent abdominal surgery due to peritonitis. The investigators expect that the incidence of hemodynamic instability will be reduced and the survival of the patients will be improved.
Often sepsis remains undiagnosed at the very beginning because of the concentration to the surgical pathology in perioperative period. This results in unacceptably high mortality. The investigators hypothesize that extended hemodynamic monitoring by focused transthoracic echocardiography will personalize early fluid resuscitation which will improve patient's outcome. The goals of the investigators study are: * To conduct two-group randomized controlled clinical trial to compare patient management based on standard monitoring and extended hemodynamic monitoring by focused transthoracic echocardiography in patients undergoing urgent abdominal surgery due to peritonitis. * To demonstrate that patient management based on extended hemodynamic monitoring by focused echocardiography results in improved survival, reduced incidence of hemodynamic instability during perioperative period. * To compare an amount of administrated of intravenous fluids in both groups. The investigators hypothesize that focused echocardiography monitoring will result in more administrated intravenous fluids during perioperative period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
131
Focused assessed transthoracic echocardiography is non-invasive, painless procedure. The transducer is placed on the chest at certain locations and angles to get the required information on patient's condition.
Lithuanian university of health sciencies
Kaunas, A. Mickeviciaus Street 9, Lithuania
Inpatient mortality in both treatment arms.
Comparison of 30 days intra-hospital mortality in both arms.
Time frame: 30 days intra-hospital mortality
Comparison of incidence of severe hypotension MAP <65 mmHg after anaesthesia induction in both arms.
To evaluate the incidence of severe hypotension after anesthesia induction (1 - 5 minutes after induction) in both groups.
Time frame: 1-5 minutes after anaesthesia induction.
Comparison of fluid management in both arms (from hospitalisation to the surgery, during the surgery, after the surgery up to 24 hours).
Comparison of tow fluids management strategies. Usual monitoring group - fluid management based on fluid responsiveness based by clinical sings. FATE group - fluid management based on focused transthoracic echocardiography data.
Time frame: up to 24 hours
Comparison of septic shock incidence in both arms.
To compare the manifestation of septic shock (hemodynamics instability not responding to fluid administration, which requires norepinephrine infusion to maintain MAP ≥ 65 mmHg);
Time frame: up to 30 days
Number of ICU-Free days.
To compare ICU free days in both groups.
Time frame: up to 30 days
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