Fluid Responsiveness in Post-cardiac Surgery

Tanta University90 enrolled

Overview

the study aims to examine the validity of combined end-expiratory and end-inspiratory occlusion test and tidal volume challenge test for prediction of fluid responsiveness in immediate post-cardiac surgery patients

multiple studies prove that dynamic variables based on heart-lung interactions accurately can predict fluid responsiveness in mechanically ventilated patients, including pulse pressure variation (PPV) and stroke volume (SV) variation. Furthermore, passive leg raising (PLR), end-expiratory occlusion test, and tidal volume challenge test, "Mini"-fluid challenge are currently available to assess fluid responsiveness.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Fluid Overload Cardiac Surgery Postoperative Complications

Interventions

Combined end-expiratory occlusion and end-inspiratory occlusion testPROCEDURE

The EEO test will be performed by interrupting the mechanical ventilation at end-expiration over 15 seconds using the end-expiratory hold button available on the ventilator. The EIO test will be performed by interrupting the mechanical ventilation at end-inspiration over 15 seconds using the end-inspiratory hold button available on the ventilator.

Tidal volume challenge testPROCEDURE

elevating tidal volume from 6 ml/kg to 8 ml/kg for only 60 seconds

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients on mechanical ventilation * Patients ≥18 years of age * patients undergoing cardiac surgery (coronary artery bypass graft, valve repair/ replacement, combined cardiac surgery) * patients with normal systolic function of the left and right ventricle * patient is mechanically ventilated with a protective lung strategy Exclusion Criteria: * Patients with Spontaneously breathing activity * Patients undergoing emergent cardiac surgery. * Patient with severe peripheral arterial occlusive disease * Pregnant women * Contraindication of passive leg raising test * unstable post-operative course * Post-operative complications such as uncontrolled bleeding, severe neurologic impairment, or accidental mechanical complications; * presence of residual severe tricuspid or any valvular regurgitations * low cardiac output, low ejection fractions (EF ≤45%) * open chest,Pao2/Fio2 ≤ 200

Locations (1)

Faculty of medicine, Tanta university

Tanta, El Gharbyia, Egypt

Outcomes

Primary Outcomes

The number of volume responder participants could be detected using each fluid responsiveness test

The number of volume responder participants could be detected using each fluid responsiveness test including tidal volume challenge test and combined end-expiratory occlusion and end-inspiratory occlusion test

Time frame: immediate postoperative period

Data from ClinicalTrials.gov

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