Fluid Administration Limited by Lung Ultrasonography in the Operating Room: Correlation to Stroke Volume Variation. (ORFALU)

Centre Hospitalier Universitaire, Amiens

Status: Completed

Conditions: Surgery

Treatments: Other: Operating Room Fluid Administration Lung Ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT03502460

PI2017_843_0018

Details and patient eligibility

About

The possibility of exploring the lungs by lung ultrasound, a non-invasive tool, is becoming increasingly popular for anesthesiologists. Recently, Lichtenstein has described the FALLS protocol (Fluid Administration Limited by Lung Sonography) which uses the potential of pulmonary ultrasound to evaluate early pulmonary overload due to fluid administration at a subclinical stage. Indeed, fluid administration can generate a sub-clinical interstitial syndrome that can be detected by passing from a profile A to a profile B in lung ultrasound. The transition from a profile A to a profile B therefore corresponds to the transition from a state of preload dependent to a state of preload independence. However, this tool has not been studied in the operating room. The main objective of this study will be to study the correlation between pulmonary ultrasound and SV variation measured by esophageal Doppler during fluid administration in patients with haemodynamic optimisation in the operating room during digestive, urological, gynecological and orthopedic surgeries. The main expected result is the following: good correlation between the absence of increased SV in the esophageal Doppler and the appearance of a B-profile lung ultrasound fluid administration in the operating room.

Enrollment: 200 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 ans
• inclusion criteria:
• Patient having a digestive, urological, gynecological, vascular or orthopedic surgery
• Haemodynamic optimisation requiring titration of the fluid administration
• Informed consent signed

Exclusion criteria

• Non-consent
• Chronic pulmonary pathology: COPD with pulmonary emphysema, pulmonary fibrosis

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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200 participants in 1 patient group

ORFALU

Other group

Description:

Lung ultrasound consists of the application of a high-frequency ultrasound probe type Trans Thoracic Echography (ETT) on the anterior and lateral chest of the patient. Since air and bone do not pass through the US, it is the artefacts due to these structures that constitute ultrasound lung semiology. Esophageal Doppler is a means of monitoring cardiac output measuring stroke volume (SV).

Treatment:

Other: Operating Room Fluid Administration Lung Ultrasound