In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. The authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. As a preload index, the predictability of central venous pressure, pulse pressure variation and stroke volume variations may be impaired due to the impaired hemodynamics that result from the effect of increased abdominal pressure and decreased venous return. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. Therefore, the authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
50
Administration of volulyte 300 ml and measurement of increase in cardiac index
Seoul National University Hospital
Seoul, South Korea
fluid responsiveness
fluid responsiveness is determined when increase in cardiac index is more than 10%
Time frame: 5 minutes after administration of 300 ml volulyte
central venous pressure
T1: baseline measurement of central venous pressure with positive end-expiratory pressure of zero
Time frame: one hour after the initiation of pneumoperitoneum
cardiac index
T1: baseline measurement of cardiac index with positive end-expiratory pressure of zero
Time frame: one hour after the initiation of pneumoperitoneum
stroke volume variation
T1: baseline measurement of stroke volume variation with positive end-expiratory pressure of zero
Time frame: one hour after the initiation of pneumoperitoneum
abdominal pressure
T1: baseline measurement of abdominal pressure with positive end-expiratory pressure of zero
Time frame: one hour after the initiation of pneumoperitoneum
central venous pressure
T2: measurement of positive end-expiratory pressure-induce increase in central venous pressure
Time frame: 5 minutes after the application of positive end-expiratory pressure of 10 cmH2O
cardiac index
T2: measurement of cardiac index
Time frame: 5 minutes after the application of positive end-expiratory pressure of 10 cmH2O
stroke volume variation
T2: measurement of stroke volume variation
Time frame: 5 minutes after the application of positive end-expiratory pressure of 10 cmH2O
abdominal pressure
T2: measurement of abdominal pressure
Time frame: 5 minutes after the application of positive end-expiratory pressure of 10 cmH2O
central venous pressure
T3: second baseline measurement of central venous pressure with positive end-expiratory pressure of zero
Time frame: 5 minutes after removal of positive end-expiratory pressure
cardiac index
T3: second baseline measurement of cardiac index with positive end-expiratory pressure of zero
Time frame: 5 minutes after removal of positive end-expiratory pressure
stroke volume variation
T3: second baseline measurement of stroke volume variation with positive end-expiratory pressure of zero
Time frame: 5 minutes after removal of positive end-expiratory pressure
abdominal pressure
T3: second baseline measurement of abdominal pressure with positive end-expiratory pressure of zero
Time frame: 5 minutes after removal of positive end-expiratory pressure
central venous pressure
measurement of central venous pressure after fluid administration
Time frame: T4: 5 minutes after administration of volulyte 300 ml
cardiac index
measurement of cardiac index after fluid administration
Time frame: T4: 5 minutes after administration of volulyte 300 ml
stroke volume variation
measurement of stroke volume variation after fluid administration
Time frame: T4: 5 minutes after administration of volulyte 300 ml
abdominal pressure
measurement of abdominal pressure after fluid administration
Time frame: T4: 5 minutes after administration of volulyte 300 ml
arterial oxygen partial pressure (mmHg)
arterial blood gas analysis
Time frame: 5 minutes after anesthesia induction
arterial carbon dioxide partial pressure (mmHg)
arterial blood gas analysis
Time frame: 5 minutes after anesthesia induction
arterial oxygen partial pressure (mmHg)
arterial blood gas analysis
Time frame: 1 minutes after the application of positive end-expiratory pressure of 10 cmH2O
arterial carbon dioxide partial pressure (mmHg)
arterial blood gas analysis
Time frame: 1 minutes after the application of positive end-expiratory pressure of 10 cmH2O
arterial oxygen partial pressure (mmHg)
arterial blood gas analysis
Time frame: 1 minutes after the start of skin closure
arterial carbon dioxide partial pressure (mmHg)
arterial blood gas analysis
Time frame: 1 minutes after the start of skin closure
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