Dynamic Preload Dependence Indices in Laparoscopic Surgery (VPP Coelio)

Civil Hospices of Lyon

Status: Completed

Conditions: Laparoscopic Surgery

Treatments: Procedure: Study of preload dependence indices after volume expansion in laparoscopy with Saldinger technique.

Study type: Interventional

Funder types: Other

Identifiers

NCT02541656

2014-879

Details and patient eligibility

About

A goal-directed fluid management is definitely beneficial in high risk surgery. The fluid administration can be directed by cardiac output monitoring which evaluate the response to repeated fluid challenge or by preload dependence indices. These indices are not well validated in laparoscopic surgery while pneumoperitoneum can alter venous return or pulmonary compliance.

The aim of the study is to study the validity of pulse pressure variation to predict fluid response under laparoscopic conditions and to describe the effect of the pneumoperitoneum on the dynamic preload indicators, i.e. the pulse pressure variation, the plethysmographic waveform of pulse oximetry variation and the stroke volume variation.

Enrollment: 40 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Need to laparoscopic colectomy or hepatic resection
• Written informed consent

Exclusion criteria

• Cardiac arrhythmia
• Esophageal and cervical pathologies
• Radial artery Allen test negative
• Allergy to anesthesic treatment, to egg or soja
• Severe kidney failure (estimated glomerular filtration rate < 30 ml/min)
• Age < 18 years old
• Pregnancy

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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40 participants in 1 patient group

preloaddependence indice after volume expansion in laparoscopy

Experimental group

Description:

The measurements of pulse pressure variation, plethysmographic waveform of pulse oximetry variation and stroke volume variation will be performed before pneumoperitoneum at the beginning of the surgery, and will be repeated after pneumoperitoneum insufflation applying each time modification of preload conditions (applying reverse Trendelenburg position followed by Trendelenburg position). The responses will be appreciated by the measurements of the stroke volume.

Treatment:

Procedure: Study of preload dependence indices after volume expansion in laparoscopy with Saldinger technique.