Uncalibrated Pulse Contour to Assess Fluid Responsiveness in Off Pump Cardiac Surgery (UPC-OPCS)

Centre Hospitalier Universitaire de la Réunion

Status: Not yet enrolling

Conditions: Coronary Surgery

Study type: Observational

Funder types: Other

Identifiers

NCT06822361

2024-A02390-47 (Other Identifier)

2024/CHU/57

Details and patient eligibility

About

The goal of this observational study is to Compare the performance of uncalibrated pulse wave contour analysis compared with transesophageal echocardiography (TEE) to assess response to a vascular filling test during beating-heart coronary artery bypass surgery, in people over age of 18; hospitalized for scheduled beating heart bypass surgery The aim question is to evaluate the ability of a less invasive cardiac output monitor (uncalibrated pulse wave contour analysis) compared with a reference cardiac output measurement (transesophageal echocardiography) to enable optimization of vascular filling by good assessment of the response to vascular filling in a high-risk perioperative patient population.

As part of hemodynamic monitoring, every patient undergoing beating-heart coronary bypass surgery is fitted with a radial arterial catheter immediately after induction of anesthesia, enabling continuous measurement of blood pressure. Hemodynamic optimization in these patients also involves fitting a transesophageal ultrasound probe to optimize cardiac output using the various therapies available (vascular filling, vasopressors, inotropes).

A specific sensor (FloTrac°, Hemosphere, Edwards°) will be connected to the arterial pressure line to obtain a systolic ejection volume value by analyzing the contour of the uncalibrated pulse wave.

The hemodynamic management of the patient, and the decision to perform a vascular filling test, will be left to the discretion of the practitioner in charge of the patient in the operating room.

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patient :

• 18 years of age and older
• Hospitalized for scheduled beating-heart coronary bypass surgery
• Beneficiary of a social security plan
• Not opposed to participating

Exclusion criteria

• Patients undergoing surgery with extracorporeal circulation
• Patients with a history of surgery or intra-esophageal pathology contraindicating TEE
• Patient refusing to participate in the study
• Unavailability of TEE or uncalibrated pulse-wave contour device
• Minors
• Protected adults, adults unable to give consent and not under protective supervision
• Persons deprived of liberty, hospitalized without consent
• Pregnant women, parturients and nursing mothers
• Patients not affiliated to the social security system
• Emergency situations