Predictability of the Pulse Pressure Variation (PPV) During Spontaneous Ventilation on the Incidence of Hypotension During Induction of Anesthesia

Study Overview
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Brief Summary
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The purpose of this study is to find out the predictability of the pulse pressure variation during spontaneous ventilation on the incidence of hypotension during induction of anesthesia.

Official Title
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Predictability of the Pulse Pressure Variation During Spontaneous Ventilation on the Incidence of Hypotension During Induction of Anesthesia

Conditions
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Hypotension

Intervention / Treatment
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* Other: PPV>14%
* Drug: Volume loading
* Other: PPV<14%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing general anesthesia induction with intravenous anesthesia using propofol and remifentanil Patients requiring invasive arterial blood pressure monitoring for the surgery Exclusion Criteria: Refusal of consent Patients with heart disease (symptomatic valvular heart disease, intracardiac shunt, pulmonary hypertension with pulmonary systolic arterial pressure exceeding 40mmHg) FEV1 ≤ 50% predicted FEV1 Patients with chronic renal failure ASA class IV, V, VI Systolic arterial blood pressure below 90mmHg before induction of anesthesia

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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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: P(+)V(+)<br>PPV>14% before anesthesia induction, HES 6ml/kg infused | Other: PPV>14%<br>* Patients whose preoperative pulse pressure variation during spontaneous ventilation exceed 14<br>Drug: Volume loading<br>* Hydroxyethyl starch solution 6ml/kg iv injection<br>|
| Experimental: P(+)V(-)<br>PPV>14% before anesthesia induction, no additional volume infused | Other: PPV>14%<br>* Patients whose preoperative pulse pressure variation during spontaneous ventilation exceed 14<br>|
| Experimental: P(-)V(+)<br>PPV<14% before anesthesia induction, HES 6ml/kg infused | Drug: Volume loading<br>* Hydroxyethyl starch solution 6ml/kg iv injection<br>Other: PPV<14%<br>* Patients whose preoperative pulse pressure variation during spontaneous ventilation does not exceed 14<br>|
| Experimental: P(-)V(-)<br>PPV<14% before anesthesia induction, no additional volume infused | Other: PPV<14%<br>* Patients whose preoperative pulse pressure variation during spontaneous ventilation does not exceed 14<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of heart rate and systolic arterial blood pressure from baseline values immediately before tracheal intubation | First, we measure the baseline heart rate and systolic arterial blood pressure and calculate the baseline heart rate and blood pressure. At 3 minutes after anesthesia agent injection we record the heart rate and blood pressure, and perform endotracheal intubation. Then we calculate the percentile change of blood pressure and heart rate from the baseline values. | Three minutes after anesthesia agent injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of heart rate and systolic arterial blood pressure from baseline values, three minutes before intubation | We collect the patient's vital signs for 1 second interval during anesthesia induction. We collect the patient's heart rate and blood pressure values for three minutes before endotracheal intubation, and average the numbers. Then we compare the numbers from the baseline value and calculate the changes. | Three minutes before endotracheal intubation | 
| Changes of heart rate and systolic arterial blood pressure from baseline values, three minutes after intubation | We collect the patient's vital signs for 1 second interval during anesthesia induction. We collect the patient's heart rate and blood pressure values for three minutes after endotracheal intubation, and average the numbers. Then we compare the numbers from the baseline value and calculate the changes. | Three minutes after endotracheal intubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hypotension during anesthesia induction