Ignite Creation Date:
2024-05-06 @ 7:15 PM
Last Modification Date:
2024-10-26 @ 3:03 PM
Study NCT ID:
NCT05945303
Status:
COMPLETED
Last Update Posted:
2023-10-17
First Post:
2023-07-06
Brief Title:
Correlation Between Internal Jugular Vein Ultrasound and Electrical Cardiometry
Sponsor:
Egymedicalpedia
Organization:
Egymedicalpedia
Study Overview
Official Title:
Correlation Between Internal Jugular Vein Ultrasound and Electrical Cardiometry in Assessment of Fluid Responsiveness in Patients Undergoing Coronary Artery Bypass Grafting Surgery
Status:
COMPLETED
Status Verified Date:
2023-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Coronary artery bypass graft CABG surgery is one of the most frequently performed cardiac surgery procedures worldwide CABG has been used for more than 40 years to relieve symptoms and to reduce the risk of death in patients with ischemic heart disease
Detailed Description:
Cardiopulmonary bypass can produce changes in fluid physiology and fluid responsiveness in patients characterized by increased interstitial fluid as a consequence of decreased cardiac output and inflammatory changes This shift of fluid from intravascular space to the intrtstitial space in addition to blood and fluid losses during the surgical procedure can result in an intravascular hypovolemia that requires fluid resuscitation
Fluid management is one of the most important treatments for stabilizing hemodynamics in patients during and after cardiac surgery Hypovolemia may leads to inadequate organ perfusion whereas fluid overload may lead to postoperative complications such as congestive heart failure or pulmonary edema In addition to patients who underwent cardiac surgery have a certain degree of myocardial stunning and hence cautions should be taken regarding fluid management in patients with limited cardiac reserve
Fluid responsiveness FR is generally defined as an increase of 10-15 in stroke volume SV cardiac output CO or cardiac index CI in response to volume expansion and indicates unmasked hypovolemia or preload dependacy
The methods for assessing fluid responsiveness have been evolved from static and volume parameters such as central venous pressure CVP pulmonary artery occlusion pressure PAOP inferior vena cava IVC and superior vena cava SVC diameters right ventricular end-diastolic volume and right ventricular end-diastolic volume which are unable to predict fluid responsiveness to dynamic indices such as pulse pressure variation PPVstroke volume variation SVV Pleth variability index PVI and aortic blood flow which is based on heart-lung interactions during mechanical ventilation which have amodest degree of accuracy
Techniques based on either a virtual or real fluid challenge such as passive led raising PLR and rapid fluid challenge 100-250cc have a high degree of accuracy in predicting fluid responsiveness
Over the last decade a number of studies have used heart-lung interactions during mechanical ventilation to assess fluid responsiveness specifically pulse pressuer variation PPV derived from analysis of the arterial blood pressure wave form stroke volume variation SVV derived from pulse-contour analysis measured by lithium dilution cardiac output monitoring system LiDDCO or pulse index continuous cardiac output monitoring system PiCCO and the variation of the amplitude of the pulse oximter plethysmographic waveform have been shown to be highly predictive of fluid responsiveness
However dynamic parameters are unreliable during spontaneous breathing activity To overcome the limited accuracy of these hemodynamic parameters in this specific clinical scenario a passive leg raising PLR manoeuver has been suggested to be reliable predictor of fluid responsiveness during spontaneous breathing
SVV can be monitored with the PiCCO system requiring transpulmonary thermodilutionIt is an invasive procedure requires the venous access and balloon flotation of the catheter through the right side
Accordingly there are complications associated with detection with this system and some are even fatal Furthermore this system requires an elaborate protocol for intermittent injections into pulmonary artery catheter thermodilution
Fluid management is one of the most important treatments for stabilizing hemodynamics in patients during and after cardiac surgery Hypovolemia may leads to inadequate organ perfusion whereas fluid overload may lead to postoperative complications such as congestive heart failure or pulmonary edema In addition to patients who underwent cardiac surgery have a certain degree of myocardial stunning and hence cautions should be taken regarding fluid management in patients with limited cardiac reserve
Fluid responsiveness FR is generally defined as an increase of 10-15 in stroke volume SV cardiac output CO or cardiac index CI in response to volume expansion and indicates unmasked hypovolemia or preload dependacy
The methods for assessing fluid responsiveness have been evolved from static and volume parameters such as central venous pressure CVP pulmonary artery occlusion pressure PAOP inferior vena cava IVC and superior vena cava SVC diameters right ventricular end-diastolic volume and right ventricular end-diastolic volume which are unable to predict fluid responsiveness to dynamic indices such as pulse pressure variation PPVstroke volume variation SVV Pleth variability index PVI and aortic blood flow which is based on heart-lung interactions during mechanical ventilation which have amodest degree of accuracy
Techniques based on either a virtual or real fluid challenge such as passive led raising PLR and rapid fluid challenge 100-250cc have a high degree of accuracy in predicting fluid responsiveness
Over the last decade a number of studies have used heart-lung interactions during mechanical ventilation to assess fluid responsiveness specifically pulse pressuer variation PPV derived from analysis of the arterial blood pressure wave form stroke volume variation SVV derived from pulse-contour analysis measured by lithium dilution cardiac output monitoring system LiDDCO or pulse index continuous cardiac output monitoring system PiCCO and the variation of the amplitude of the pulse oximter plethysmographic waveform have been shown to be highly predictive of fluid responsiveness
However dynamic parameters are unreliable during spontaneous breathing activity To overcome the limited accuracy of these hemodynamic parameters in this specific clinical scenario a passive leg raising PLR manoeuver has been suggested to be reliable predictor of fluid responsiveness during spontaneous breathing
SVV can be monitored with the PiCCO system requiring transpulmonary thermodilutionIt is an invasive procedure requires the venous access and balloon flotation of the catheter through the right side
Accordingly there are complications associated with detection with this system and some are even fatal Furthermore this system requires an elaborate protocol for intermittent injections into pulmonary artery catheter thermodilution
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None