Augmented Pulse Pressure Variation to Predict Fluid Responsiveness in Open Laparotomy

Samsung Medical Center

Status: Completed

Conditions: Abdominal Neoplasms; Gynecologic Neoplasms

Treatments: Other: Fluid loading; Other: Augmented ventilation

Study type: Observational

Funder types: Other

Identifiers

NCT02653469

SMC 2015-06-015

Details and patient eligibility

About

Pulse pressure variation (PPV) is a well-known and widely used dynamic preload indicator based on heart-lung interaction to predict fluid responsiveness. Generally, patients are considered to be fluid-responsive when the PPV value larger than 11-13%. However, several previous researches demonstrated that there is a zone of uncertainty (grey zone) in PPV. To predict fluid-responsiveness accurately in the patients with PPV within grey zone (9-13%), the investigators would evaluate the augmented PPV using augmented ventilation.

Enrollment: 38 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients undergoing elective open laparotomy surgery.

Exclusion criteria

• Irregular heart beats,
• cardiac arrhythmia,
• moderate or severe valvular heart disease,
• preoperative left ventriular ejection fraction less than 40%,
• moderate t severe obstructive pulmonary disease,
• preoperative need of inotropics infusion,
• preoperative serum Cr > 1.3ml/dl,
• moderate to severe renal or liver disease,
• acute lung injury or acute lung problem,
• coexisting open chest condition,
• severe bradycardia,
• patients with spontaneous breathing

Trial design

38 participants in 1 patient group

Augmented ventilation with fluid loading

Description:

This is an observational study and as a diagnostic intervention, subjects in the study would receive mechanical ventilation with augmented tidal volume of 12ml/kg for 2min. Augmented ventilation is performed when the patient's PPV is within grey zone (9-13%). The investigators perform this procedure to every patients and do not assigh this intervention to the subjects of the study. Then, 6ml/kg of ballanced crystalloid loading will be infused to every patient.

Treatment:

Other: Augmented ventilation

Other: Fluid loading