Preoperative Blood Volume Optimization Using Transthoracic Echocardiography

Launched by UNIVERSITY HOSPITAL, CAEN · Oct 10, 2024

Keywords

ClinConnect Summary

The EchOptimal study is exploring a method to improve blood flow before surgery to help prevent low blood pressure (called arterial hypotension) that can occur after anesthesia is given. This low blood pressure is a concern because it can lead to serious health issues during and after surgery. The study will compare two groups of patients: one group will receive standard care after anesthesia, while the other group will have their blood flow optimized before surgery using a special ultrasound technique called transthoracic echocardiography (TTE). The goal is to see if preparing patients this way can lower the chances of experiencing low blood pressure right after anesthesia.

To participate in this study, patients need to be 18 years or older, have a higher risk of heart problems, and be scheduled for surgery that requires general anesthesia. They should also be well-informed about the study and give their consent to participate. Participants will be closely monitored during the first 15 minutes after anesthesia to check their blood pressure and ensure their safety. This study is currently recruiting participants, and it aims to provide important insights that could improve patient care during surgeries.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient aged 18 years or older,
• • Affiliated with social security,
• • Informed about the study and having signed the informed consent form,
• • Requires surgical intervention under general anesthesia,
• • Intermediate or high risk of cardiovascular events within 30 days,
• • ASA phyiscal status Classification 3 or 4
• Exclusion Criteria:
• • - Pregnant or breastfeeding women,
• • Patients under guardianship, curatorship, judicial protection, or legal protection,
• • Minors,
• • Patients with contraindications to intravenous induction with Propofol and Remifentanil,
• • Patients not fasting at the time of surgery,
• • Patients with an immediate life-threatening emergency or requiring surgery without delay to ensure survival,
• • Patients with contraindications for placing an arterial pressure catheter in the radial artery: bilateral negative Allen's test indicating absence of ulnar collateral circulation, Raynaud's syndrome, Buerger's disease, severe dyslipidemias,
• • Patients with characteristics making the measurement of ITVSAo uninterpretable: atrial fibrillation, non-sinus electrocardiogram, severe valvulopathy, documented right or left heart failure,
• • Patients under general anesthesia before arrival in the operating room,
• • Patients receiving aminergic support before anesthetic induction,
• • Patients requiring rapid sequence induction,
• • Patients treated with ACE inhibitors/ARBs who have not discontinued the treatment on the day of the procedure