Spectral Analysis of Central Venous Pressure Waveform

JongHae Kim

Status: Completed

Conditions: Hypovolemia; Donor Hepatectomy; Central Venous Catheter

Treatments: Device: Monitoring of stroke volume variation; Drug: Furosemide-induced hypovolemia before graft procurement; Device: Monitoring of central venous pressure; Procedure: Placement of a central venous catheter; Drug: Replacement of fluid loss after graft procurement

Study type: Observational

Funder types: Other

Identifiers

NCT04733547

CR-21-007

Details and patient eligibility

About

The use of central venous pressure has been abandoned for the assessment of intravascular volume status. The dynamic fluctuation of central venous pressure according to heart rate is quantitatively measured by spectral analysis of the central venous pressure waveform. Its clinical utility in the assessment of intravascular volume status is investigated.

Full description

The use of central venous pressure, which is one of the static preload indices, has been abandoned for the assessment of intravascular volume status because of its unreliability. The static preload indices have been replaced with dynamic preload indices, such as stroke volume variation or pulse pressure variation because the dynamic preload indices reliably predict fluid responsiveness and perform better than the static preload indices. However, the periodic component of central venous pressure, which goes with cardiac cycles, has not been investigated. The power corresponding to heart rate from spectral analysis of central venous pressure waveform represents the extent of the dynamic fluctuation of central venous pressure and is assumed to reflect intravascular volume status. It is hypothesized that the spectral power of central venous pressure corresponding to heart rate represents intravascular volume status.

Enrollment: 60 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists physical status 1
• Scheduled for donor hepatectomy under general anesthesia

Exclusion criteria

• Arrhythmia
• Valvular heart disease
• Coronary artery disease
• Cerebrovascular disease
• Hypertension
• Diabetes mellitus
• Renal insufficiency
• Pulmonary problems
• Any type of liver disease
• Body mass index greater than 35 kg/m2
• Human immunodeficiency virus infection
• Psychosocial problems
• Electrolyte imbalance
• Reoperation

Trial design

60 participants in 1 patient group

Donor hepatectomy

Description:

Live donors undergoing hepatectomy

Treatment:

Device: Monitoring of central venous pressure

Procedure: Placement of a central venous catheter

Drug: Replacement of fluid loss after graft procurement

Device: Monitoring of stroke volume variation

Drug: Furosemide-induced hypovolemia before graft procurement