Clinical trial NCT04971122: Comparison of the Effects of Trendelenburg Position and Passive Leg Lift on Hemodynamics in Abdominal Surgery Patients
Official title: Comparison of the Effects of Trendelenburg Position and Passive Leg Lift on Hemodynamics in Abdominal Surgery Patients
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: The Angle of Trendelenburg
Lead sponsor: The Second Affiliated Hospital of Dalian Medical University
Sponsor class: OTHER
First posted: 2021-07-21
Enrollment: 54
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: How to maintain the stability of circulation during anesthesia has always been a concern of clinicians, including shorting the preoperative fasting time under the condition of full preoperative preparation, and giving appropriate amount of nutrient solution in combination with the patient's situation 2\~4 h before surgery to reduce the blood volume insufficiency of patients before general anesthesia induction, vasoactive drugs, etc. Among them, passive leg lifting experiment is widely recognized in the world. Although passive leg lifting has many advantages, it still has some limitations in the operation process. This study tried to find the corresponding head low and foot high Angle corresponding to the same hemodynamic changes caused by passive leg lifting.

Detailed description: For low head and high feet, studies have shown that 20° can reduce the incidence of hypotension during the induction period of general anesthesia in patients undergoing gastrectomy and has therapeutic effect on it, as well as reduce the use of vasoactive drugs during the induction period of general anesthesia. There were no perioperative complications.

The passive leg lift test can be repeated and does not overload the patient with fluid. However, there is no relevant research on the relationship between the two, which is exactly the innovation of this topic.

Eligibility criteria: Inclusion Criteria:

* Age 18\~75 years old
* Good image of TTE can be obtained
* Sedative mechanical ventilation （Vt 8～10ml/kg）
* Circulation was relatively stable before the experiment began
* There is no contraindication to rehydration

Exclusion Criteria:

* TTE acquisition is not ideal
* Patients did not agree to participate in the experiment
* Diseases of the central nervous system，patients with increased intracranial pressure
* Arrhythmia patients;
* Patients with increased intra-abdominal pressure;
* Bedridden patients;
* Patients with venous thrombosis of lower limbs;
* Patients with venous foreign body of lower limbs;
* Patients with circulatory instability;
* Patients with obstructive shock;
* Patients with moderate or above heart valve reflux

Primary outcomes:
measure: PPV(pulse pressure variation)
timeFrame: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
measure: VTI(velocity time integral)
timeFrame: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
Secondary outcomes:
measure: SBP(Systolic Blood Pressure)
timeFrame: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
measure: MAP(Mean Artery Pressure)
timeFrame: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
measure: HR HR(Heart Rate)
timeFrame: T1:A supine position with a 10° upward bed angulation；T2: After passive leg lift；T3：The same position with T1；T4:After trendelenburg position；T5:The same position with T1;T6:After fluid infusion
Other outcomes:
Locations:
city: Dalian
country: China
facility: The Second Affiliated Hospital of Dalian Medical University
state: Liaoning
Study officials:
affiliation: Dalian Medical University
name: Dan Hua, Master
role: PRINCIPAL_INVESTIGATOR
References: