TEE as a Guide for Fluid Optimization in Major Abdominal Oncosurgery

NCT ID: NCT03140540

Last Updated: 2020-10-26

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-16

Study Completion Date

2020-02-27

Brief Summary

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Transesophageal echocardiography (TEE) as guide for tailoring perioperative fluid therapy to achieve individualized hemodynamic endpoint, target hemodynamic goals of stroke volume index (SVI) greater than 35 mL/m2 and cardiac index greater than 2.5 L/min/m2 and tissue oxygen delivery.

Lactate levels as a surrogate indicator of organ perfusion as measured by arterial blood gas analysis intraoperatively, after 12 hours and 48 hrs postoperatively

Detailed Description

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TEE as guide for tailoring perioperative fluid therapy to achieve target hemodynamic goals of stroke volume index (SVI) greater than 35 mL/m2 and cardiac index greater than 2.5 L/min/m2 and tissue oxygen delivery.

GDT (goal directed therapy): continuous infusion of crystalloids 2 mL/kg/h.

If (velocity time integral) VTI \<20, 250 mL colloid bolus administered. Dose repeated every 10 min until goal of VTI \>20 met. Norepinephrine titrated to maintain MAP(mean arterial pressure) \> 65 mm Hg. Blood transfused for haemoglobin \<8 g Lactate levels as a surrogate indicator of organ perfusion as measured by arterial blood gas analysis at time of incision intraoperatively and after 12 hours and 48 hrs. The incidence of postoperative complications, morbidity, mortality, duration of mechanical ventilation and ICU stay.

Conditions

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Fluid Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

TEE as guide for tailoring perioperative fluid therapy to achieve individualized hemodynamic endpoint , target hemodynamic goals of stroke volume index (SVI) greater than 35 mL/m2 and cardiac index greater than 2.5 L/min/m2 and tissue oxygen delivery. Lactate levels as a surrogate indicator of organ perfusion as measured by arterial blood gas analysis intraoperatively , after 12 hours and 48 hrs postoperatively.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Caregivers
The intensivist taking care of the patient postoperatively not aware of the intervention

Study Groups

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Group A (stroke volume variation) guided fluid

Stroke volume variation guided intraoperative intravenous fluid will be administered.

Group Type ACTIVE_COMPARATOR

Stroke volume variation guided intravenous fluid.

Intervention Type OTHER

Active Comparator: Group A control group (SVV guided fluid ) Stroke volume variation guided intraoperative intravenous fluid will be administered. SVV \>10, 200 ml of colloid bolus to be given

Group B(Study group) TEE guided fluid

Transesophageal echocardiography will be used to guide the fluid therapy.

Group Type ACTIVE_COMPARATOR

TEE guided fluid therapy will be administered

Intervention Type OTHER

Transesophageal echocardiography will be used to guide the fluid therapy. Velocity time integral of aorta \<20 ,200ml colloid bolus to be administered.

Interventions

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TEE guided fluid therapy will be administered

Transesophageal echocardiography will be used to guide the fluid therapy. Velocity time integral of aorta \<20 ,200ml colloid bolus to be administered.

Intervention Type OTHER

Stroke volume variation guided intravenous fluid.

Active Comparator: Group A control group (SVV guided fluid ) Stroke volume variation guided intraoperative intravenous fluid will be administered. SVV \>10, 200 ml of colloid bolus to be given

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ASA 1, 2 and 3
* Undergoing major abdominal oncosurgery

Exclusion Criteria

* Any contraindication for TEE probe insertion as oesophageal varices , oesophageal and gastric carcinoma , severe left ventricular hypertrophy , coagulopathy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rajiv Gandhi Cancer Institute & Research Center, India

OTHER

Sponsor Role lead

Responsible Party

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Dr soumi pathak

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Rajiv Gandhi Cancer Institute

Delhi, , India

Site Status

Countries

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India

References

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Guarracino F. [The role of transesophageal echocardiography in intraoperative hemodynamic monitoring]. Minerva Anestesiol. 2001 Apr;67(4):320-4. Italian.

Reference Type RESULT
PMID: 11376533 (View on PubMed)

Trinooson CD, Gold ME. Impact of goal-directed perioperative fluid management in high-risk surgical procedures: a literature review. AANA J. 2013 Oct;81(5):357-68.

Reference Type RESULT
PMID: 24354071 (View on PubMed)

Other Identifiers

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RGCI ID:500/AN/ANK-02

Identifier Type: -

Identifier Source: org_study_id