Pulse Pressure Variation Measured During Valsalva Maneuver to Predict Fluid Responsiveness Under Open-chest Condition

NCT02457572 | Completed

• 1 other identifier: SMC 2014-07-005
• Study Type: observational
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

Pulse pressure variation (PPV) is a well-known dynamic preload indicator to predict fluid responsiveness. However, its usefulness in open-chest conditions has been equivocal. The investigators evaluated whether PPV measured during Valsalva maneuver can predict fluid responsiveness after sternotomy.

Conditions

Cardiac Surgical Procedures; Thoracic Surgical Procedures; Sternotomy

Outcome Measures

Primary Outcomes (1)

• Pulse pressure variation during Valsalva maneuver

  during Valsalva maneuver

Secondary Outcomes (1)

• Pulse pressure variation after sternotomy

  5 min after sternotomy

Study Arms (1)

Valsalva maneuver

This is an observational study and as a diagnostic intervention, subjects in the study would receive valsalva maneuver. Valsalva maneuver was performed after sternotomy with the constant airway pressure of 30cmH2O for 2 breaths duration. The investigators perform this procedure to every patients and do not assign this intervention to the subjects of the study.

Procedure: Valsalva maneuver; Other: Fluid loading

Interventions

Valsalva maneuver PROCEDURE

Valsalva maneuver was performed after sternotomy with the constant airway pressure of 30cmH2O for 2 breaths duration.

Also known as: Lung recruitment maneuver

Valsalva maneuver

Fluid loading OTHER

We record the cardiac index values before and after volume expansion with 6ml/kg of balanced crystalloid

Also known as: Balanced crystalloid infusion

Valsalva maneuver

Eligibility Criteria

• Age: 20 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Adult patients undergoing elective off-pump coroanry arterial bypass grafting

You may qualify if:

• \- Adult patients undergoing elective off-pump coronary arterial bypass grafting

You may not qualify if:

• Preoperative LV EF \<= 35%
• Moderate or severe valvular heart disease
• Cardiac arrhythmia
• Intracardiac shunt
• Severe renal or liver disease
• Moderate to severe pulmonary hypertension (mean PAP \> 35 mmHg)
• Patients with bullous lung disease or combined pneumothorax

Sponsors & Collaborators

• Samsung Medical Center: lead

Study Sites (1)

Samsung Medical Center

Seoul, 135-710, South Korea

Location

Related Publications (1)

• Min JJ, Kim TK, Lee JH, Park J, Cho HS, Kim WS, Lee YT. Evaluation of augmented pulse pressure variation using the Valsalva manoeuvre as a predictor of fluid responsiveness under open-chest conditions: A prospective observational study. Eur J Anaesthesiol. 2017 May;34(5):254-261. doi: 10.1097/EJA.0000000000000613.

  PMID: 28207430 DERIVED

MeSH Terms

Interventions

Valsalva Maneuver

Intervention Hierarchy (Ancestors)

Heart Function Tests; Diagnostic Techniques, Cardiovascular; Diagnostic Techniques and Procedures; Diagnosis; Respiratory Function Tests; Diagnostic Techniques, Respiratory System; Hemodynamics; Cardiovascular Physiological Phenomena; Circulatory and Respiratory Physiological Phenomena; Respiratory Physiological Phenomena

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Study Record Dates

• First Submitted: April 22, 2015
• First Posted: May 29, 2015
• Study Start: October 1, 2014
• Primary Completion: May 1, 2015
• Study Completion: May 1, 2015
• Last Updated: September 14, 2015

Record last verified: 2015-09

Locations

KR (1)