Goal Directed Fluid Management Based on Non-invasive Monitoring

NCT ID: NCT01883752

Last Updated: 2016-02-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

334 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2013-10-31

Brief Summary

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The purpose of this study is to evaluate whether goal directed fluid management using respiratory variations in the oxygen saturation by pulse oximetry (SpO2) waveform has potential to decrease postoperative complications and outcomes.

Detailed Description

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The aim of this study is to test the hypothesis that monitoring and minimizing the respiratory variations in the pulse oximeter waveform amplitude by volume loading has potential to decrease postoperative morbidity and length of stay in the hospital in patients undergoing routine, moderate-risk elective surgery.

In this study the investigators will test the impact of hemodynamic optimization based on the respiratory variations in the plethysmographic waveform amplitude to decrease postoperative morbidity and length of stay in the hospital in patients undergoing routine, moderate-risk elective surgery. The primary outcome variable is the incidence of postoperative complications. Secondary outcome variables are the duration of hospital and ICU stays, postoperative mortality, and cost of surgery.

Conditions

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Postoperative Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

Baseline crystalloid infusion of 5 mL/kg/hr of body weight.

Group Type NO_INTERVENTION

No interventions assigned to this group

Goal-directed Therapy group

Goal-direct therapy

Group Type EXPERIMENTAL

Goal-directed Therapy group

Intervention Type PROCEDURE

Fluid administration is based on the respiratory variation in the pulse oximeter waveform

Interventions

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Goal-directed Therapy group

Fluid administration is based on the respiratory variation in the pulse oximeter waveform

Intervention Type PROCEDURE

Other Intervention Names

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Goal Directed Fluid Optimization group

Eligibility Criteria

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Inclusion Criteria

* Patients (male or female)
* Over 18 years old undergoing non-cardiac surgery
* Weight \> 40 kg, Body Mass Index \< 40

Exclusion Criteria

* Patients who do not consent
* Body Mass Index \> 40
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Irvine

OTHER

Sponsor Role lead

Responsible Party

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Maxime Cannesson

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maxime Cannesson, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

UC Irvine Medical Center, Dept of Anesthesiology & Perioperative Care

Locations

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University of California, Irvine Medical Center

Orange, California, United States

Site Status

Countries

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United States

References

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Bennett-Guerrero E, Welsby I, Dunn TJ, Young LR, Wahl TA, Diers TL, Phillips-Bute BG, Newman MF, Mythen MG. The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery. Anesth Analg. 1999 Aug;89(2):514-9. doi: 10.1097/00000539-199908000-00050.

Reference Type BACKGROUND
PMID: 10439777 (View on PubMed)

Mythen MG, Webb AR. Intra-operative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med. 1994;20(2):99-104. doi: 10.1007/BF01707662.

Reference Type BACKGROUND
PMID: 8201106 (View on PubMed)

Chappell D, Jacob M, Hofmann-Kiefer K, Conzen P, Rehm M. A rational approach to perioperative fluid management. Anesthesiology. 2008 Oct;109(4):723-40. doi: 10.1097/ALN.0b013e3181863117.

Reference Type BACKGROUND
PMID: 18813052 (View on PubMed)

Lebuffe G, Vallet B, Takala J, Hartstein G, Lamy M, Mythen M, Bakker J, Bennett D, Boyd O, Webb A. A european, multicenter, observational study to assess the value of gastric-to-end tidal PCO2 difference in predicting postoperative complications. Anesth Analg. 2004 Jul;99(1):166-72. doi: 10.1097/00000539-200407000-00034.

Reference Type BACKGROUND
PMID: 15281524 (View on PubMed)

Sinclair S, James S, Singer M. Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ. 1997 Oct 11;315(7113):909-12. doi: 10.1136/bmj.315.7113.909.

Reference Type BACKGROUND
PMID: 9361539 (View on PubMed)

Venn R, Steele A, Richardson P, Poloniecki J, Grounds M, Newman P. Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures. Br J Anaesth. 2002 Jan;88(1):65-71. doi: 10.1093/bja/88.1.65.

Reference Type BACKGROUND
PMID: 11881887 (View on PubMed)

Wakeling HG, McFall MR, Jenkins CS, Woods WG, Miles WF, Barclay GR, Fleming SC. Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth. 2005 Nov;95(5):634-42. doi: 10.1093/bja/aei223. Epub 2005 Sep 9.

Reference Type BACKGROUND
PMID: 16155038 (View on PubMed)

Gan TJ, Soppitt A, Maroof M, el-Moalem H, Robertson KM, Moretti E, Dwane P, Glass PS. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology. 2002 Oct;97(4):820-6. doi: 10.1097/00000542-200210000-00012.

Reference Type BACKGROUND
PMID: 12357146 (View on PubMed)

Conway DH, Mayall R, Abdul-Latif MS, Gilligan S, Tackaberry C. Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery. Anaesthesia. 2002 Sep;57(9):845-9. doi: 10.1046/j.1365-2044.2002.02708.x.

Reference Type BACKGROUND
PMID: 12190747 (View on PubMed)

Poeze M, Greve JW, Ramsay G. Meta-analysis of hemodynamic optimization: relationship to methodological quality. Crit Care. 2005;9(6):R771-9. doi: 10.1186/cc3902. Epub 2005 Nov 15.

Reference Type BACKGROUND
PMID: 16356226 (View on PubMed)

Other Identifiers

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UCIANES01

Identifier Type: -

Identifier Source: org_study_id

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