Clinical trial NCT04982016: Effects of Fluid Therapy on Microcirculatory Reactivity
Official title: Effects of Preoperative Fluid Therapy on Microcirculatory Reactivity in Patients With MIDCAB After General Anesthesia
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Microcirculation
Fluid Therapy
Keywords: minimally invasive coronary artery bypass grafting
fuid therapy
microcirculation
Lead sponsor: Beijing Anzhen Hospital
Sponsor class: OTHER
First posted: 2021-07-29
Enrollment: 126
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Through preoperative fluid therapy, to investigate whether it can alleviate the microcirculation dysfunction after induction of anesthesia, and reduce the incidence of perioperative fluid therapy-related complications, thereby accelerating rehabilitation.

Detailed description: Patients undergoing minimally invasive coronary artery bypass graft surgery were randomly divided into crystal group, colloid group and control group. The preoperative fluid reactivity was evaluated according to the passive leg lifting test (PLR). When stroke volume increased (△SV)\>16%, the patients in the crystal (carbonate Ringer solution) and the colloid group (hydroxyethyl starch solution) were treated with volume therapy, while the control group was not treated with PLR test and volume therapy. Vascular occlusion test was used to observe the effect of anesthesia induction on tissue oxygen saturation recovery slope (RecStO2) after volume therapy, Goal-directed fluid therapy was used during operation, and the postoperative microcirculation function and the incidence of related complications were observed.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years old
* Plan to undergo elective minimally invasive coronary artery bypass grafting (left anterior descending branch);
* Sign informed consent

Exclusion Criteria:

* Left ventricular ejection fraction \<40%
* Diabetes
* Renal insufficiency (serum creatinine\>177umol/L)
* Liver insufficiency (AST, ALT\>3 times)
* Peripheral vascular disease
* Carotid artery stenosis (\>60%) VOT test contraindications (arm deformity, burns, arteriovenous shunt)
* Use glucocorticoids, vasoactive drugs, inotropic drugs or intra-aortic balloon counterpulsation (IABP)
* Allergic to colloidal fluids

Primary outcomes:
measure: Change in DesStO2 is assessed
timeFrame: The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
measure: Change in tM is assessed
timeFrame: The microcirculation function is measured at 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
Secondary outcomes:
measure: Change in mean arterial pressure is assessed
timeFrame: 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
measure: Change in heart rate is assessed
timeFrame: 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
measure: Length of hospital stay
timeFrame: up to 60 days
measure: Duration of stay in the intensive care unit
timeFrame: up to 60 days
measure: Change in HS is assessed
timeFrame: 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
measure: Change in SDC-1 is assessed
timeFrame: 4 time points: patients entered the operating room; 5 minutes after volume therapy; 30 minutes after anesthesia induction; and at the end of the operation
Other outcomes:
Locations:
Study officials:
affiliation: Anzhen hospital Beijing China
name: Boqun Cui, Doctor
role: PRINCIPAL_INVESTIGATOR
References: