Non Invasive Methods to Guide Volume Optimization

Launched by LENA NILSSON · Oct 24, 2011

Keywords

ClinConnect Summary

The patients are not allowed to eat after midnight. Routine premedication is given with paracetamol and oxynorm/oxycontin. Thrombosis and antibiotic prophylaxis is given according to surgical department.

The weight of the patient is notices on the morning of surgery (day 0).

The patient arrives in the morning to the preoperative area. A urinary analysis is taken for urinary colour, creatinine, specific weight, osmolality, microalbuminuria and electrolytes. For 30 patients a volume kinetic analysis of 5 ml/kg infusion of acetated Ringers solution is undertaken between 6.30 and 8.00 am on t...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Open abdominal surgery under general anaesthesia with a planned operation time of at least 120 minutes
• • 2. Age ≥ 18 years
• Exclusion Criteria:
• • 1. Anaesthesia risk classification ASA ≥ 4
• • 2. Arrhythmia; atrial fibrillation or multiple extra systoles
• • 3. Aortic - or mitral insufficiency with hemodynamic influence
• • 4. Patients who at the preoperative visit by the responsible anaesthesiologist is planned for a more advanced cardiovascular monitoring. The following monitoring is accepted in the study: invasive blood pressure, 5-lead ECG, central venous pressure and urinary output per hour.
• • 5. Patients with a pulmonary or other disease that prevents ventilation using a tidal volume of 7 ml/kg (ideal weight) or a positive end expiratory pressure of 5 -10 cm H2O
• • 6. Contra indication against synthetic colloids as severely impaired renal or liver function, hyper natremia or allergy to synthetic colloids
• • 7. Laparoscopic surgery
• • 8. Liver surgery
• • 9. Surgery including thoracotomy
• • 10. Contraindications against an oesophageal probe such as severe oesophageal varicose veins