Cardiac Output Monitoring With Estimated Continuous Cardiac Output (esCCO) vs. Transpulmonary Thermodilution (TPTD)

Northern State Medical University

Status: Completed

Conditions: Pulse Wave Analysis

Treatments: Other: Fluid responsiveness tests

Study type: Interventional

Funder types: Other

Identifiers

NCT02352324

esCCO-vs-TPTD

Details and patient eligibility

About

The main goal of our study is to assess the accuracy and reproducibility of continuous beat-to-beat cardiac output (CO) measurement using pulse wave transit time in patients undergoing off-pump coronary artery bypass grafting.

Full description

Using appropriate statistical methods the cardiac index values obtained via pulse wave transit time with esCCO system will be compared with traditional transpulmonary thermodilution technique.

Enrollment: 20 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Elective isolated off-pump coronary arteries bypass grafting.
• Age > 18 years and < 80 yrs.
• Preoperative echocardiographic ejection fraction > 0.35

Exclusion criteria

• Simultaneous operation (carotid endarterectomy, ventricular aneurysm resection, etc.).
• Constant form of atrial fibrillation.
• Severe valve dysfunction.
• Peripheral vascular disease (including significant peripheral arteriopathy" which precludes the use of peripheral plethysmography).
• The surgical requirement to harvest both radial arteries.
• Intraaortic balloon pump.

Discontinuation Criteria:

• Transfer to cardiopulmonary bypass (on-pump CABG).
• The PEEP test will be discontinued before standard duration in patients with PEEP-induced profound MAP decrease below 50 mm Hg, bradycardia (< 50/min) or CIPCA < 1.9 l/min/m2 exceeding 1 minute.

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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20 participants in 1 patient group

Fluid responsiveness tests

Experimental group

Description:

After the end of surgery in ICU the positive end-expiratory pressure (PEEP) test of 15 cm H2O for 300 seconds will be performed. Following PEEP test, the two-step fluid load test of 6 ml/kg balanced crystalloid solution will be performed sharing in two portions: Initial mini FLT (mFLT) of 1.5 ml/kg within 1 min (approximately 100 mL) followed by the registration of continuous CI and traditional fluid responsiveness parameters and the rest of standard FLT (4.5 mL/kg) within 5 minutes (approximately 350 mL) followed by transpulmonary thermodilution, registration of continuous cardiac index (CI) and classic fluid responsiveness parameters.

Treatment:

Other: Fluid responsiveness tests