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Influence of Perioperative Fluid Therapy on Hemoglobin and Methemoglobin Levels

U

University of Rostock

Status

Completed

Conditions

Perioperative/Postoperative Complications
Fluid Overload
Hemoglobin H

Treatments

Other: GDT

Study type

Observational

Funder types

Other

Identifiers

NCT03220620
A 2017-0073

Details and patient eligibility

About

The objective of the study is to evaluate influence of perioperative fluid therapy on Methemoglobin levels, and to changes in hemoglobin. Further, changes in Methemoglobin will be related to metabolic signs of oxidative stress (changes in blood lactate). Patients undergoing major abdominal surgery will be included into the study.

Full description

Increasing plasma volume by intravenous administration of crystalloid and/or colloid solutions may cause a relative reduction in hemoglobin (Hb) concentration, a situation that is termed 'dilutional anemia'. Such hemodilution may lead to an iatrogenic reduction in oxygen-carrying capacity and the development of organ dysfunction. Paradoxically, large amounts of fluids that are administered with the aim of increasing oxygen delivery (DO2), as is frequently done as part of perioperative goal-directed therapy; this may lead to an actual decrease in the DO2 due to a decrease in Hb concentration.

Another potential parameter that may reflect the development of dilutional anemia is methemoglobin (MetHb), a form of Hb with reduced ability for oxygen binding. Experimental studies showed that dilutional anemia may lead to up-regulation of perivascular nitric oxide synthase (NOS) and increase NOS-derived nitric oxide (NO) leading to local vasodilation and oxidization of Hb to MetHb. MetHb may potentially serve as a biomarker of 'anemic stress' associated with reduced tissue perfusion during acute hemodilution.

Enrollment

60 patients

Sex

All

Ages

18 to 90 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • major abdominal surgery
  • informed consent

Exclusion criteria

  • violation of study protocol

Trial design

60 participants in 2 patient groups

GDT Group
Description:
receives goal-directed therapy
Treatment:
Other: GDT
Not GDT Group
Description:
receives no individualized goal-directed therapy

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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