Heart Failure and Hemodynamic Stability During Anesthesia Induction

Umeå University44 enrolled

Overview

The study aim is to investigate whether preoperative heart failure has impact on hemodynamic stability during anesthesia induction by target controlled infusion of anesthesia (TCI) in non-cardiac, non-morbidly obese surgery.

40 individuals are enrolled to the study after signed informed consent at the day of surgery. The study participants are randomized (non-blinded) to preoperative fluid therapy (preoperative colloid fluid bolus at 6 ml/kg LBW, Gelofusine™, Fresenius Kabi AB, Sweden) or control (no preoperative fluids) before standardized TCI- induction of anesthesia. No other intravenous fluids before anesthesia induction. Preoperative screening of biventricular systolic and diastolic function of the heart and level of venous return is implemented by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Hemodynamic Instability Anesthesia; Adverse Effect Heart Failure Diastolic Dysfunction Venous; Return (Anomaly)

Interventions

Preoperative colloid fluid bolus (Gelofusine)OTHER

Preoperative colloid fluid bolus

Preoperative transthoracic echocardiographyDIAGNOSTIC_TEST

Screening of biventricular systolic and diastolic function of the heart and level of venous return by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age over 18 years * body mass index ≤ 35 kg/m2 * electively scheduled for breast cancer surgery, endocrinologic surgery (thyroid, parathyroid) and general abdominal surgery Exclusion Criteria: * instable angina pectoris * severe bronchial asthma * severe COPD * dementia * severe heart valve disease * severe renal failure * body mass index \> 35 kg/m2

Locations (1)

Sunderby teaching hospital

Luleå, Sweden

Outcomes

Primary Outcomes

Incidence of blood pressure drops

Blood pressure drop below mean arterial pressure at 65 mmHg during anesthesia induction. Non-invasive blood pressures (systolic, mean and diastolic) are measured 5 minutes before anesthesia induction and thereafter every 5 minutes post-induction .