Clinical trial NCT06855966: Feasibility of ETCO₂ Changes During Passive Leg Raise for Fluid Management in Lung Surgery
Official title: Assessment of End-Tidal Carbon Dioxide Changes in Response to Passive Leg Raise for Guiding Fluid Management in Lung Resections: a Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Lung Cancer
Lead sponsor: Istanbul University - Cerrahpasa
Sponsor class: OTHER
First posted: 2025-03-04
Enrollment: 53
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

Brief summary: Aim: End tidal carbondioxide pressure (EtCO2) is an indirect indicator of cardiac output (CO) which is monitored in every patient at perioperative setting. The investigators aimed to use increase of EtCO2 as a response to passive leg raising maneuver (PLR) to indicate fluid responsiveness in patients who underwent lung resection with video-assisted thoracoscopic surgery (VATS).

Detailed description: Materials and Methods: 50 patients included who are eligible according to inclusion criteria of the study who underwent lung resection operation via VATS between Agust 2020-March 2021. After a standardized anesthesia induction protocol and intubation, PLR is applied to all patients as soon as anesthesia depth and ventilation stabilized. An increase of 2 mmHg at EtCO2 at first minute of PLR evaluated as "fluid responsive" due to an increase of venous return. Responsive patients divided into two groups as "study" and "control" when unresponsive patiens inclueded into "unresponsive" group. Patients at study group received a fluid bolus (250 ml (and an additional 250 ml if mean arterial pressure remained below 65 mmHg )) in addition to maintainence fluid as control group and unresponsive group received only maintainence fluid. Hemodynamic data, surgery duration, total iv fluid administration, use of blood products, bleeding and urine output during surgery of all patients recorded. Preopretive and postoperative urea, creatinine and lactate levels of all patiens compared. Total iv fluid administration and urine output recorded during postoperative 24 hours.

Eligibility criteria: Inclusion Criteria:

* Patients undergoing lung resection surgery via VATS
* ASA I-II-III
* Patients older than 18 years

Exclusion Criteria:

* ASA IV or more
* Post operative ICU stay
* Resections greater than lobectomy
* History of renal and heart failure
* Patients younger than 18 years.

Primary outcomes:
measure: Change in End-Tidal Carbon Dioxide (EtCO₂) in Response to Passive Leg Raise (PLR)
timeFrame: Time Frame: Intraoperative (Baseline and 1 Minute After PLR)
Secondary outcomes:
measure: Change in Serum Urea Levels
timeFrame: Preoperative, 24 hours, and 48 hours postoperatively (if patient remains hospitalized)
measure: Change in Serum Creatinine Levels
timeFrame: Preoperative, 24 hours, and 48 hours postoperatively (if patient remains hospitalized)
measure: Change in Serum Lactate Levels
timeFrame: Preoperative, 24 hours
Other outcomes:
measure: Correlation Between Pleth Variability Index (PVI) and Fluid Responsiveness Based on EtCO₂ Changes
timeFrame: Time Frame: Intraoperative (Baseline and during 1 Minute of PLR maneuer)
Locations:
city: Istanbul
country: Turkey
facility: Istanbul University-Cerrahpasa Medical School Hospital
Study officials:
affiliation: Istanbul University - Cerrahpasa
name: Lale Yuceyar, Professor
role: STUDY_DIRECTOR
References: