Predictor of Postoperative Complications After Lengthy Noncardiac Surgery (complication)

Cairo University (CU)

Status: Completed

Conditions: Peripheral Perfusion Index

Treatments: Diagnostic Test: Peripheral Perfusion index; Diagnostic Test: serum lactate level

Study type: Observational

Funder types: Other

Identifiers

NCT04680663

MS-390-2020

Details and patient eligibility

About

Many patients undergoing long time surgery will manifest increased level of blood lactate.

Hyperlactacidemia can cause disturbance of internal environment, then leading to increased complications and longer ICU stay, even death. For postoperative patients, we must ensure adequate perfusion in order to minimize the length of hyperglycemia and improve patients' outcomes. With regard to lactate, it provides information about prefusion, but not timely enough for its delay on reflecting hypoperfusion. And it's not real-time and non-invasive.

Peripheral perfusion index (PPI) is an indicator reflecting hypoperfusion in critical patients. It is measured using pulse co-oximetry technology which is characterized by being real-time and noninvasive. PPI is defined as "the ratio of pulsatile blood flow to the non-pulsatile blood flow", mirroring the strength of blood flow and quality of perfusion at sensor site, reflecting perfusion state of the body part . In contrast to lactate value, it's real-time and easy to monitor.

Enrollment: 235 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

• Inclusion criteria
• Adult patients above 18 years of age.
• Both genders
• surgical time planned to be > 120 minutes .
• surgical time predicted to exceed the planned time and prolongation of surgical time > 120 minutes occured will be included in the study .
• ASA physical status of I-II
• Patients scheduled for elective surgery under general anaesthesia .
• Exclusion criteria
• Refused to participate .
• patient with disease affecting blood flow to the hands where probe will be applied .
• patient with hand injuries so probe cannot be applied
• Patient with sever renal and liver disease
• Discharging against medical advice or reported death during ICU stay at first 48 hours after ICU admission .
• Pregnancy or emergency surgery .
• shortening of the planned surgical time to be less than 120 minutes

Trial design

235 participants in 2 patient groups

Non complications group

Description:

where the non-complicated patients is the patients running the normal postoperative course of surgery and without any need for intervention

Treatment:

Diagnostic Test: serum lactate level

Diagnostic Test: Peripheral Perfusion index

complications group

Description:

any deviation from the normal post-operative course

Treatment:

Diagnostic Test: serum lactate level

Diagnostic Test: Peripheral Perfusion index