Validity of Mini Fluid Challenge Post Liver Transplantation

Study Overview
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Brief Summary
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our study aim to assess the validity of using mini fluid challenge to assess the volaemic status of patients after liver transplantation

Detailed Description
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After approval of institutional ethical committee and after informed patient consent, patients fulfilling criteria will be involved. Upon ICU admission, patients will be connected to full monitoring and confirming patient hemodynamic stability and no active bleeding through drains. Patients will be in supine position and baseline readings will be recorded. Fluid responsiveness will be assessed with mini fluid challenge by 150 ml of albumin 5% given over 1 minute. After fluid administration stroke volume (SV) assessed by trans thoracic echo (TTE) and other hemodynamic parameters will be recorded. Remaining 350 ml of albumin 5% will be continued over 14 minute to have total volume given 500 ml. after fluid administration SV and other parameters will be recorded. The fluid challenge will be given intravenously via a specific wide pore venous line. Fluid responsiveness will be defined as an increase in the SV by 15% after the infusion of fluid. TT Echo Examination: A single LVOT diameter will be measured for each patient as the distance between the inﬂection points at the base of the aortic valve cusps from the left parasternal long axis view during systole. Assuming a circular cross section, the LVOT area will be calculated from the LVOT diameter as: π X (LVOT diameter/ 2)2 = (LVOT diameter)2 X 0.785 Pulse wave Doppler sampling cursor will be placed in the middle of the LVOT immediately proximal to the aortic valve in 5 chamber apical view. The sonographer manually will trace the velocity-time envelope (VTI). SV values will be calculated by multiplying VTI by cross sectional area.

Official Title
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Validity of Mini Fluid Challenge to Assess Fluid Responsiveness Post Liver Transplantation

Conditions
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Liver Transplantation

Intervention / Treatment
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* Diagnostic Test: mini fluid challenge


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients post liver transplantation. ASA III- IV Age > 18 years Exclusion Criteria: Age less than 18 years. Patient with fulminant liver failure.

Ages Eligible for Study
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Minimum Age: 18 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: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: mini fluid challenge<br>mini fluid will be given and stroke volume will be assessed before and after | Diagnostic Test: mini fluid challenge<br>* mini fluid challenge will be given to diagnose if patient is need fluid resuscitation or not<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| stroke volume | assessed by trans thoracic echo | 1 minute after mini fluid administration | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| heart rate |  | baseline 10 minutes after intensive care admission, 1 minute after mini fluid challenge and 1 minute after 500 ml of fluid administration | 
| stroke volume | assessed by trans thoracic echo | baseline 10 minutes after intensive care admission and 1 minute after 500 ml of fluid administration | 
| mean arterial blood pressure |  | baseline 10 minutes after intensive care admission and 1 minute after 500 ml of fluid administration | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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liver transplantation, mini fluid challenge