Atrial Natriuretic Peptide in Assessing Fluid Status

Petrovsky National Research Centre of Surgery

Status: Completed

Conditions: Cardiac Disease; Fluid Loss; Fluid Overload; Cardiac Output, Low; Volume Overload; Cardiac Output, High

Treatments: Diagnostic Test: pro-ANP

Study type: Interventional

Funder types: Other

Identifiers

NCT05070819

0394227092021

Details and patient eligibility

About

Biomarkers can play a significant role in fluid status assessment intraoperatively.

Full description

Routinely intraoperatively the fluid status assessment is based on central venous pressure and other parameters. Nevertheless, the minority of anesthesiologists use continous dynamic parameters like pulse pressure variation, stroke volume variation and other to manage fluid status. There's a fast acting biomarker that can help anesthesiologist to diagnose and manage the volemic status and possibly guide the infusion therapy better.

Pro-ANP is a biomarker that reacts on atria strain and can be used in volemic status assessment in cardiac surgery patients.

Enrollment: 30 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

CABG, one-, two valve repair/replacement, ascending aorta, aortic arch replacement, ASD/AVD closure, septal myectomy

Exclusion criteria

1. Atrial fibrillation, atrial flutter, frequent ventricular and supraventricular arrythmias
2. EFLV < 50%
3. Pulmonary hypertension > 2 st
4. CKD > C3 (GFR < 30)
5. Redo surgery
6. Left atrium volume > 150 ml
7. LV EDV > 250 ml

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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30 participants in 1 patient group

Cardiac surgery patients

Experimental group

Description:

1. After admission to OR and arterial catheter is placed the pro-ANP probe is obtained. 2. After anesthesia induction, trachea intubation before Teboul' test pro-ANP is obtained 3. At the end of Teboul' test when lower limbs are lifted 4. 30 minutes of CPB 5. End of CPB 6. End of volume transition from CPB circuit to patient 7. Before Teboul' test at the end of surgery 8. End of Teboul' test when lower limbs are lifted

Treatment:

Diagnostic Test: pro-ANP