Effects of Fluid Therapy on Microcirculatory Reactivity

Capital Medical University

Status: Unknown

Conditions: Fluid Therapy; Microcirculation

Treatments: Other: colloid therapy; Other: crystal therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04982016

2020093X

Details and patient eligibility

About

Through preoperative fluid therapy, to investigate whether it can alleviate the microcirculation dysfunction after induction of anesthesia, and reduce the incidence of perioperative fluid therapy-related complications, thereby accelerating rehabilitation.

Full description

Patients undergoing minimally invasive coronary artery bypass graft surgery were randomly divided into crystal group, colloid group and control group. The preoperative fluid reactivity was evaluated according to the passive leg lifting test (PLR). When stroke volume increased (△SV)>16%, the patients in the crystal (carbonate Ringer solution) and the colloid group (hydroxyethyl starch solution) were treated with volume therapy, while the control group was not treated with PLR test and volume therapy. Vascular occlusion test was used to observe the effect of anesthesia induction on tissue oxygen saturation recovery slope (RecStO2) after volume therapy, Goal-directed fluid therapy was used during operation, and the postoperative microcirculation function and the incidence of related complications were observed.

Enrollment: 126 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years old
• Plan to undergo elective minimally invasive coronary artery bypass grafting (left anterior descending branch);
• Sign informed consent

Exclusion criteria

• Left ventricular ejection fraction <40%
• Diabetes
• Renal insufficiency (serum creatinine>177umol/L)
• Liver insufficiency (AST, ALT>3 times)
• Peripheral vascular disease
• Carotid artery stenosis (>60%) VOT test contraindications (arm deformity, burns, arteriovenous shunt)
• Use glucocorticoids, vasoactive drugs, inotropic drugs or intra-aortic balloon counterpulsation (IABP)
• Allergic to colloidal fluids

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

---

126 participants in 3 patient groups

Control group

No Intervention group

Description:

There is no treatment before anesthesia induction.

Crystal group

Experimental group

Description:

The fluid reactivity was determined by PLR test before anesthesia induction. The basic value was measured when maintain the head height at 45° for 2 min. and the liquid reactivity value was measured when both legs were raised 45° for 2 min. If △SV \>16%, restore the head height to 45°, and 250ml carbonated Ringer's solution was infused (infusion time \>10min).

Treatment:

Other: crystal therapy

Colloidal group

Experimental group

Description:

The fluid reactivity was determined by PLR test before anesthesia induction. The basic value was measured when maintain the head height at 45° for 2 min. and the liquid reactivity value was measured when both legs were raised 45° for 2 min. If △SV \>16%, restore the head height to 45°, and 250ml colloidal fluid was infused (infusion time \>10min).

Treatment:

Other: colloid therapy