Could the Stroke Volume Variation Predict a Fluid Responsiveness in Thoracotomy?

NCT ID: NCT02331056

Last Updated: 2016-10-07

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 79 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2014-07-31
• Study Completion Date: 2015-06-30

Brief Summary

There are some risks of pulmonary edema in patients undergoing pulmonary lobectomy with one lung ventilation. The overloading of fluid administration could be related to the development of pulmonary edema in patents after thoracic surgery. But fluid restriction may cause major organ hypoperfusion during the surgery. The purpose of this study is to evaluate the ability of stroke volume variation as an indicator for a fluid responsiveness in patient who receives pulmonary lobectomy via thoracotomy.

Detailed Description

Perioperative fluid management during thoracic surgery is a significantly important, because it is quite difficult to prevent pulmonary edema due to the fluid overload and compromise perfusion of vital organ. So, it is essential to maintain optimal organ perfusion by appropriate fluid management during thoracic surgery. Stroke volume variation (SVV) is derived from pulse contour analysis and it is known that SVV ≥12~15% correlate with fluid responsiveness, defined as a significant increase in cardiac output with fluid loading, dung two-lung ventilation. It is a parameter derived from changes in stroke volume (SV) that is according to the heart-lung interaction during mechanical ventilation. positive pressure ventilation induces cyclic changes in left ventricular SV that are related mainly to the expiratory decrease in right ventricular filling and ejection. This is a reflected by variations in the SV. However both ventilator issues, such as tidal volume, PEEP, chest and lung condition, and the cardiovascular condition, such as heart rate, rhythm, ventricular function, cardiac afterload, arterial compliance may affect SVV. Recently some studies reported that SVV could predict fluid responsiveness in mechanically ventilated patients under various conditions. But it is still unclear whether SVV could predict fluid responsiveness during one lung ventilation with the chest open via a thoracotomy. During one-lung ventilation, the shunted blood flow through the non-ventilated-lung dose not contribute to the generation of SVV. And with the chest opening by thoracotomy, the pressure generated by ventilator would not be transmitted to the pulmonary vessels but rather to the atmosphere. So, the purpose of this study is to evaluate the ability of SVV as an indicator a fluid responsiveness particularly in patients undergoing one-lung ventilation with thoracotomy and to found the optimal threshold value of SVV for fluid management during thoracic surgery.

Conditions

Pulmonary Neoplasm; Pulmonary Tuberculosis

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: PROSPECTIVE

Study Groups

thoracoscopic pulmonary lobectomy

to observe a fluid responsiveness in patients who receives scheduled thoracoscopic pulmonary lobectomy

fluid loading

Intervention Type: OTHER

Fluid loading at defined period

• 500ml colloid solution infusion at 20min after thorax open for 30min. 500ml colloid administration is a kind of routine procedure during pulmonary lobectomy in our hospital. We just control the fluid loading timing for hemodynamic parameter records.

thoracoscopic pulmonary lobectomy

Intervention Type: PROCEDURE

the patient group for scheduled thoracoscopic pulmonary lobectomy

open pulmonary lobectomy(thoracotomy)

to observe a fluid responsiveness in patients who receives scheduled open pulmonary lobectomy(thoracotomy)

fluid loading

Intervention Type: OTHER

Fluid loading at defined period

• 500ml colloid solution infusion at 20min after thorax open for 30min. 500ml colloid administration is a kind of routine procedure during pulmonary lobectomy in our hospital. We just control the fluid loading timing for hemodynamic parameter records.

thoracotomy

Intervention Type: PROCEDURE

the patient group for scheduled open pulmonary lobectomy

Interventions

fluid loading

Fluid loading at defined period

• 500ml colloid solution infusion at 20min after thorax open for 30min. 500ml colloid administration is a kind of routine procedure during pulmonary lobectomy in our hospital. We just control the fluid loading timing for hemodynamic parameter records.

Intervention Type: OTHER

thoracoscopic pulmonary lobectomy

the patient group for scheduled thoracoscopic pulmonary lobectomy

Intervention Type: PROCEDURE

thoracotomy

the patient group for scheduled open pulmonary lobectomy

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• The patients scheduled for pulmonary lobectomy with one lung ventilation by lung cancer, nodule, or pulmonary tuberculosis under thoracoscopy or thoracotomy in our hospital

Exclusion Criteria

• The patients with known cardiac disease include arrythmia
• American society of anesthesia physical status III, IV, V

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Samsung Medical Center

OTHER

Sponsor Role: lead

Responsible Party

Hyun Joo Ahn

Associate professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Hyun Joo Ahn

Role: PRINCIPAL_INVESTIGATOR

Samsung Medical Center

Locations

Samsung medical center

Seoul, , South Korea

Countries

South Korea

References

Jeong DM, Ahn HJ, Park HW, Yang M, Kim JA, Park J. Stroke Volume Variation and Pulse Pressure Variation Are Not Useful for Predicting Fluid Responsiveness in Thoracic Surgery. Anesth Analg. 2017 Oct;125(4):1158-1165. doi: 10.1213/ANE.0000000000002056.

Reference Type: DERIVED

PMID: 28504996 (View on PubMed)

Other Identifiers

2014-06-053-002

Identifier Type: -

Identifier Source: org_study_id