Fluid Responsiveness in Post Cardiac Surgery Patients

N/AEnrolling By InvitationNCT06583200

Ain Shams University46 enrolled

Overview

The aim of the study is to compare end expiratory occlusion test to passive leg raising test for prediction of fluid responsiveness in post cardiac surgery mechanically ventilated patients.

Circulatory hypervolemia and hypovolemia are both associated with worse outcomes.Intravenous fluids are similar to drugs, with serious adverse effects and changeful efficacy. Fluids should be administered only if indicated. Passive leg raising test transiently increase venous return which can be used to evaluate fluid responsiveness.There is growing evidence that the End expiratory occlusion (EEO) test reliably detects fluid responsiveness. In patients under mechanical ventilation, the inspiration increases intra-thoracic pressure and decreases venous return. The expiratory hold augments the cardiac preload which, in case of preload responsiveness, leads to a significant increase of cardiac output (CO).EEO prevents any variation in intra-thoracic pressure leading to an increase in venous return, cardiac preload and stroke volume in preload-responsive patients. There're no studies comparing EEO with passive leg raising test in cardiac surgery patients. So, this is the target of the study.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

TRIPLE

Enrollment

Conditions

Cardiac Complication

Interventions

End Expiratory Occlusion TestDIAGNOSTIC_TEST

All studied mechanically ventilated patients under post operative sedation. EEO test will be applied to predict probable responder and probable non-responder according to pulse pressure variation in accordance to previous study where the response to volume expansion was defined as an increase in pulse pressure of 5% or more

Passive Leg Raising TestDIAGNOSTIC_TEST

All studied mechanically ventilated patients under post operative sedation.Passive leg raising test will be applied to predict probable responder and probable non-responder according to the PPV in accordance to previous study where the response to volume expansion was defined as an increase in pulse pressure of at least 10%

Eligibility

Sex: ALLMin age: 21 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age group: 21-60years old * Sex: eligible both sexes * Post cardiac surgery * Sedated intubated mechanically ventilated patients (Controlled ventilation with no respiratory effort) Exclusion Criteria: * Patients refusal * Pregnancy or any medical condition that may affect the intra abdominal pressure. * Lower limb deep venous thrombosis Open chest conditions impaired left-ventricular ejection fraction (\<45%), arrhythmias, inter-ventricular shunt, severe peripheral arterial occlusive disease and the need for intra-aortic balloon counter pulsation

Locations (1)

Faculty of medicine Ain Shams University

Cairo, Cairo Governorate, Egypt

Outcomes

Primary Outcomes

Predictive value of EEO and passive leg raising

Predictive value of EEO and passive leg raising to fluid responsiveness in post cardiac surgery mechanically ventilated patients Pulse pressure variation before and after passive leg raising test

Time frame: One year

Secondary Outcomes

Arterial blood pressure

Effect of EEO and passive leg raising to fluid responsiveness on arterial blood pressure in post cardiac surgery mechanically ventilated patients

Time frame: One year

Heart rate

Effect of EEO and passive leg raising to fluid responsiveness on heart rate in post cardiac surgery mechanically ventilated patients

Time frame: One year

Data from ClinicalTrials.gov

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