Fluid Responsiveness in Post-cardiac Surgery

Tanta University

Status: Completed

Conditions: Postoperative Complications; Cardiac Surgery; Fluid Overload

Treatments: Procedure: Combined end-expiratory occlusion and end-inspiratory occlusion test; Procedure: Tidal volume challenge test

Study type: Interventional

Funder types: Other

Identifiers

NCT05957003

fluid responsiveness

Details and patient eligibility

About

the study aims to examine the validity of combined end-expiratory and end-inspiratory occlusion test and tidal volume challenge test for prediction of fluid responsiveness in immediate post-cardiac surgery patients

Full description

multiple studies prove that dynamic variables based on heart-lung interactions accurately can predict fluid responsiveness in mechanically ventilated patients, including pulse pressure variation (PPV) and stroke volume (SV) variation.

Furthermore, passive leg raising (PLR), end-expiratory occlusion test, and tidal volume challenge test, "Mini"-fluid challenge are currently available to assess fluid responsiveness.

Enrollment: 90 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients on mechanical ventilation
• Patients ≥18 years of age
• patients undergoing cardiac surgery (coronary artery bypass graft, valve repair/ replacement, combined cardiac surgery)
• patients with normal systolic function of the left and right ventricle
• patient is mechanically ventilated with a protective lung strategy

Exclusion criteria

• Patients with Spontaneously breathing activity
• Patients undergoing emergent cardiac surgery.
• Patient with severe peripheral arterial occlusive disease
• Pregnant women
• Contraindication of passive leg raising test
• unstable post-operative course
• Post-operative complications such as uncontrolled bleeding, severe neurologic impairment, or accidental mechanical complications;
• presence of residual severe tricuspid or any valvular regurgitations
• low cardiac output, low ejection fractions (EF ≤45%)
• open chest,Pao2/Fio2 ≤ 200

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 2 patient groups

occlusions test

Active Comparator group

Description:

Combined end expiratory (EEO) and inspiratory occlusion (EIO) test. A 15-s EEO separated by a time window of 1 minute to allow the hemodynamic parameters to return to baseline followed by a 15-s EIO

Treatment:

Procedure: Combined end-expiratory occlusion and end-inspiratory occlusion test

challenge test

Active Comparator group

Description:

Tidal volume (TV) challenge test (transient increase of TV from 6 to 8 mL/kg for 1 minute)

Treatment:

Procedure: Tidal volume challenge test