Positive End-expiratory Pressure-induced Increase in Central Venous Pressure as a Predictor of Fluid Responsiveness in Robot-assisted Laparoscopic Surgery

Recruiting

Phase N/A Results N/A

Trial Description

In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. The authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.

Detailed Description

In urologic robotic surgery with steep Trendelenburg position, maintenance of cardiac preload and cardiac output is important for clinical prognosis. As a preload index, the predictability of central venous pressure, pulse pressure variation and stroke volume variations may be impaired due to the impaired hemodynamics that result from the effect of increased abdominal pressure and decreased venous return. Previous studies reported the positive end-expiratory pressure (PEEP)-induced increase in central venous pressure (CVP) could be a accurate predictor of fluid responsiveness in cardiac surgical patients. Therefore, the authors attempt to evaluate the predictability of PEEP-induced increase in CVP as well as stroke volume variation in urologic robotic surgery with Steep Trendelenburg position.

Conditions

Interventions

  • Fluid loading of volulyte 300 ml Procedure
    Intervention Desc: Administration of volulyte 300 ml and measurement of increase in cardiac index
    ARM 1: Kind: Experimental
    Label: Fluid responsiveness test
    Description: First, apply 10 cmH2O positive endexpiratory pressure (PEEP) and measure the increase in central venous pressure (CVP) as well as other preload indexes (central venous pressure, mean arterial pressure, stroke volume variation). Second, measure the increase in cardiac index after administration of volulyte 300 ml. If cardiac index increase more than 10%, fluid responsiveness is confirmed.

Outcomes

Type Measure Time Frame Safety Issue
Primary fluid responsiveness 5 minutes after administration of 300 ml volulyte
Secondary central venous pressure one hour after the initiation of pneumoperitoneum
Secondary cardiac index one hour after the initiation of pneumoperitoneum
Secondary stroke volume variation one hour after the initiation of pneumoperitoneum
Secondary abdominal pressure one hour after the initiation of pneumoperitoneum
Secondary arterial oxygen partial pressure (mmHg) 5 minutes after anesthesia induction
Secondary arterial carbon dioxide partial pressure (mmHg) 5 minutes after anesthesia induction

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