The Impact of Noradrenaline on Ventriculo-arterial Coupling and Central Cardiovascular Energy Delivery
NCT ID: NCT04745845
Last Updated: 2022-01-05
Study Results
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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COMPLETED
NA
49 participants
INTERVENTIONAL
2021-03-01
2021-12-31
Brief Summary
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Detailed Description
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Initially the individual patient is either considered fluid responsive (SVV \>13%) og non- responsive (SVV\<13%) by using stroke volume variation assessed by echocardiography.
In case of fluid responsiveness a fluid bolus of 4ml/kg of crystalloid fluid is given until SVV drops below 13% and the patient can be considered as fluid NON responder.
Right afterwards the study patient is stabilized with a baseline dose of noradrenaline (NA) intravenously in a supine position (situation 1). Situation 2 will be a slight increase in NA dose stabilizing mean arterial pressure in a "baseline + 20mmHg" state. After reversing the NA dose back to base line level the patient is allowed a short period of rest to wean of drug effect (4-5 x t1/2, appr. 12min). Subsequently the patient is to be placed in a 20% semi upright position (Anti-Trendelenburg) causing an increase in fluid responsiveness (situation 3). Following a phase of equilibration the dose of NA is again titrated up to obtain a 20mmHg increase in mean arterial pressure (situation 4).
There will be logging of arterial pressure curve and VTI-tracing I LVOT simultaneously (ultrapower, uPWR) as well as calculation of energy delivery, cardiac power, oscillatory power and -fraction and both arterial and ventricular elastance in every of those 4 situations.
Conditions
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Study Design
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NA
SINGLE_GROUP
BASIC_SCIENCE
NONE
Study Groups
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Noradrenalin
treatment with 2 different NA concentrations in 2 different states of fluid responsiveness
Noradrenalin
Norepinephrine challenge (concentration 'A' ) in fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'A') in non-fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'B') in fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'B') in non-fluid responsive position
Interventions
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Noradrenalin
Norepinephrine challenge (concentration 'A' ) in fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'A') in non-fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'B') in fluid responsive position
Noradrenalin
Norepinephrine challenge (concentration 'B') in non-fluid responsive position
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* requirement for Noradrenaline/Norepinephrine
Exclusion Criteria
* patient unsuitable for mean arterial pressure (MAP) elevation of 20mmHg
* patient requiring different blood pressure range due to medical/surgical needs
* poor image quality due to patient factors
18 Years
99 Years
ALL
No
Sponsors
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St. Olavs Hospital
OTHER
Responsible Party
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Principal Investigators
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Hilde Pleym (Head of Department), md, PhD
Role: STUDY_DIRECTOR
St. Olavs Hospital
Locations
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St Olavs Hospital, Dep. for Anesthesia & Intensive care. Section of cardiothoracic Anesthesia and -intensive Care.
Trondheim, , Norway
Countries
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Other Identifiers
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2019/287
Identifier Type: -
Identifier Source: org_study_id
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