The Effect of Patient Position Changes on Advanced Cardiac Indices in Cancer Surgery

NCT06293391 | Completed

• 1 other identifier: 2022-11/2097
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Esophageal Doppler Monitoring (Deltex CardioQ Esophageal Doppler Monitor, ODM) is used to manage patients' fluid therapy by non-invasively measuring continuous cardiac output with an esophageal probe. The aim of this study was to compare the effects of patient position changes on cardiac indices and vital signs in patients who underwent major abdominal cancer surgery with laparoscopic and open surgery using ODM.

Conditions

Abdominal Cancer; Blood Pressure; Cardiac Indices

Outcome Measures

Primary Outcomes (7)

• Cardiac Output

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Stroke Volume

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Flow time corrected

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Peak Velocity

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Stroke Distance

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Mean arterial pressure

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

• Pulse

  Measurement of cardiac output with the oesophageal doppler device immediately after induction of anaesthesia and in the middle of the case in both supine and trendelenburg position of the patient to see whether there is a significant difference in positional change.

  Immediately after induction of anaesthesia and at any stable time during the case

Study Arms (2)

ODM measurements of patients undergoing open surgery in supine and trendelenburg position

After intubation, serial ODM measurements were performed in the supine and trendelenburg position of the patient and CO: Cardiac output, FTc: Flow time corrected, PV: Peak velocity, SD: Stroke distance values were recorded.

Procedure: cardiac indices in supine and trendelenburg position

ODM measurements of patients undergoing laparoscopic surgery in supine and trendelenburg position

After intubation, serial ODM measurements were performed in the supine and trendelenburg position of the patient and CO: Cardiac output, FTc: Flow time corrected, PV: Peak velocity, SD: Stroke distance values were recorded.

Procedure: cardiac indices in supine and trendelenburg position

Interventions

cardiac indices in supine and trendelenburg position PROCEDURE

Cardiac indices in supine and trendelenburg position in patients undergoing open or laparoscopic major cancer surgery

ODM measurements of patients undergoing laparoscopic surgery in supine and trendelenburg position; ODM measurements of patients undergoing open surgery in supine and trendelenburg position

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The patients included in the study were intubated after standard anaesthesia induction with fentanyl 2 mcg/kg, propofol 2 mg/kg and rocuronium 0.6 mg/kg, and ODM was used for case follow-up. All patients were followed with standard 6% desflurane anaesthetic gas and intravenous infusion of remifentanil, a short-acting opioid, after intubation. Mean arterial pressure was kept in the range of 65-80 mmHg in all patients, tidal volume was adjusted as 6-8 ml/kg, peep (positive end expiratory pressure) as 0-6 cm H2O and respiratory frequency as 10-15 /min for normocapnia. After intubation, intraoperative ODM measurements and intraoperative ODM measurements were retrospectively scanned and recorded in the supine and 45-degree angle trendelenburg position.

You may qualify if:

• Elective operation
• ASA 1-4

You may not qualify if:

• Heart failure
• Valvular heart disease,
• Patients with symptomatic rhythm disturbances
• ODM placement contraindicated (coagulopathy, oesophageal varices, known aortic aneurysm)

Sponsors & Collaborators

• Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital: lead

Study Sites (1)

Dr.Abdurrahman Yurtaslan Ankara Oncology Train and Research Hospital

Ankara, 06200, Turkey (Türkiye)

Location

Related Publications (7)

• Heinink TP, Read DJ, Mitchell WK, Bhalla A, Lund JN, Phillips BE, Williams JP. Oesophageal Doppler guided optimization of cardiac output does not increase visceral microvascular blood flow in healthy volunteers. Clin Physiol Funct Imaging. 2018 Mar;38(2):213-219. doi: 10.1111/cpf.12401. Epub 2017 Feb 6.

  PMID: 28168868 RESULT

• Yonis H, Bitker L, Aublanc M, Perinel Ragey S, Riad Z, Lissonde F, Louf-Durier A, Debord S, Gobert F, Tapponnier R, Guerin C, Richard JC. Change in cardiac output during Trendelenburg maneuver is a reliable predictor of fluid responsiveness in patients with acute respiratory distress syndrome in the prone position under protective ventilation. Crit Care. 2017 Dec 5;21(1):295. doi: 10.1186/s13054-017-1881-0.

  PMID: 29208025 RESULT

• Haas S, Haese A, Goetz AE, Kubitz JC. Haemodynamics and cardiac function during robotic-assisted laparoscopic prostatectomy in steep Trendelenburg position. Int J Med Robot. 2011 Dec;7(4):408-13. doi: 10.1002/rcs.410. Epub 2011 Aug 3.

  PMID: 21815239 RESULT

• Conway DH, Hussain OA, Gall I. A comparison of noninvasive bioreactance with oesophageal Doppler estimation of stroke volume during open abdominal surgery: an observational study. Eur J Anaesthesiol. 2013 Aug;30(8):501-8. doi: 10.1097/EJA.0b013e3283603250.

  PMID: 23549128 RESULT

• Kaye AD, Vadivelu N, Ahuja N, Mitra S, Silasi D, Urman RD. Anesthetic considerations in robotic-assisted gynecologic surgery. Ochsner J. 2013 Winter;13(4):517-24.

  PMID: 24358000 RESULT

• Huang L, Critchley LA. An assessment of two Doppler-based monitors to track cardiac output changes in anaesthetised patients undergoing major surgery. Anaesth Intensive Care. 2014 Sep;42(5):631-9. doi: 10.1177/0310057X1404200514.

  PMID: 25233178 RESULT

• Argun G, Sahin MK. The impact of patient position changes on advanced hemodynamic indices in laparoscopic and open major abdominal cancer surgeries: retrospective study. BMC Surg. 2025 Aug 6;25(1):341. doi: 10.1186/s12893-025-03064-8.

  PMID: 40770328 DERIVED

MeSH Terms

Interventions

Supine Position; Head-Down Tilt

Intervention Hierarchy (Ancestors)

Posture; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Mustafa Kemal SAHIN, M.D

  Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 15, 2024
• First Posted: March 5, 2024
• Study Start: February 1, 2023
• Primary Completion: March 1, 2023
• Study Completion: February 5, 2024
• Last Updated: April 30, 2026

Record last verified: 2026-04

Locations

TU (1)