A Gray Zone Approach to Stroke Volume Variation Derived From NICOM

Study Overview
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Brief Summary
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Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on chest wall. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.

Detailed Description
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Optimal fluid management has been considered as crucial part to determine postoperative outcome and organ function. Many reports have focussed on evaluation of fluid responsiveness using various parameters such as pulse pressure variation (PPV) or stroke volume variation (SSV) derived from invasive or semi-invasive monitoring. Recently developed, non invasive cardiac output measurement(NICOM, Cheetah Medical, Portland, OR)has enabled continuous cardiac output(CO) monitoring just by attaching electrode on thorax. Moreover, CO and SSV derived from NICOM have been demonstrated as predictors of fluid responsiveness. Therefore, the aim of this study is to evaluate stroke volume variation derived from NICOM as a predictor of fluid responsiveness in neurosurgical patients. In addition, we plan to reveal inconclusive patients using gray zone approach.

Official Title
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Evaluation of Stroke Volume Variation Derived From NICOM as a Predictor of Fluid Responsiveness in Neurosurgical Patients: A Gray Zone Approach

Conditions
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Neurological Diseases or Conditions, Fluid Responsiveness, Non Invasive Cardiac Output Monitoring, Gray Zone

Intervention / Treatment
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* Other: 500ml fluid loading


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA I or ASA II patients aged 20-80 undergoing neurosurgery in supine position Exclusion Criteria: Pre-existing arrythmic disorders Congestive heart failure required medical treatment Preoperative Creatinine 1.3mg/dl observing self respiration during the study interventions Bleeding tendency Severe brain edema

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 500ml fluid loading<br>All enrolled patients | Other: 500ml fluid loading<br>* Fluid loading to evaluate fluid responsiveness<br>* Other names: stimulation with stable hemodynamics;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke volume variation | 5min following the end of rapid fluid infusion: 5 min after the end of fluid loading | 5min following the end of rapid fluid infusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation with pulse pressure variation | 5min following the end of rapid fluid infusion: 5 min after the end of fluid loading | 5 min following the end of rapid fluid infusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neurosurgical patients, Fluid loading, Fluid responsiveness, NICOM, Stroke volume variation, Pulse pressure variation, Total peripheral resistance, Gray zone approach