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In this prospective, observational study the investigators assess the perioperative course of right ventricular function in combination with the venous return in patients undergoing major non-cardiac surgery. The study aims to investigate if patients undergoing major non-cardiac surgery develop an impairment of right ventricular function and/or venous return. Furthermore, the study evaluates if an impairment of right ventricular function and/or venous return is associated to left ventricular function, arterial side of the circulation and to postoperative clinical outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Female cancer patients with ascites | Primary epithelial ovarian female cancer patients with ascites (> 500 ml ascites in the preoperative sonographic examination) | ||
| Female cancer patients aged > 70 years | Primary epithelial ovarian female cancer patients aged > 70 years with at least one of the following secondary diagnoses:
|
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| Measure | Description | Time Frame |
|---|---|---|
| Right ventricular function | Right ventricular function will be measured perioperatively by a combination of right ventricular stroke volume, tricuspid annular plane systolic excursion (TAPSE), hepatic venous blood flow, variations in diameter of vena cavae, and right ventricle/left ventricle-ratio. | Up to the first postoperative day |
| Venous return | Venous return will be assessed perioperatively by venous return pressure gradient (dVR) | Up to the first postoperative day |
| Measure | Description | Time Frame |
|---|---|---|
| Variables of transthoracic and transesophageal echocardiography | Perioperative course of variables of transthoracic and transesophageal echocardiography | Up to the first postoperative day |
| Venous return variables according to Guyton concept |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of right ventricular function index | Right ventricular function index will be evaluated by a combination of right ventricular stroke volume, tricuspid annular plane systolic excursion (TAPSE), hepatic venous blood flow, variations in diameter of vena cavae and right ventricle/left ventricle-ratio. | Up to the first postoperative day |
Inclusion Criteria:
Offered patient information and written informed consent
Female patients aged greater than or equal to 18 years for cytoreductive surgery of a primary epithelial ovarian tumour
Patient Group 1: Female patients with > 500 ml ascites in the preoperative sonographic examination
Patient group 2: Female patients aged > 70 years and at least one of the following secondary diagnoses:
Exclusion Criteria:
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Female cancer patients being observed in the Department of Anesthesiology and Intensive Care Medicine CVK and CCM in cooperation with the Department of Gynecology and Obstetrics CVK at the Campus Virchow - Klinikum, Charité - Universitaetsmedizin Berlin
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| Name | Affiliation | Role |
|---|---|---|
| Claudia Spies, MD, Prof. | Charite University, Berlin, Germany | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology and Intensive Care Medicine, Campus Virchow Klinikum, Charité - Universitaetsmedizin | Berlin | 13353 | Germany |
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Perioperative course of variables according to Guyton concept characterizing venous return
| Up to the first postoperative day |
| Hemodynamic variables | Hemodynamic variables are assessed by the anesthesia monitor and esophageal Doppler Monitor | Up to the third postoperative day |
| Catecholamine administration | Catecholamine administration intra- und postoperative | Up to the third postoperative day |
| Immunological parameter | Perioperative immunological (IL-6 und TNF-alpha) | Up to the third postoperative day |
| Endothelial parameter | Perioperative endothelial Parameter (ICAM-1) | Up to the third postoperative day |
| Microvascular function | Perioperative course of variables assessing microvascular function | Up to the first postoperative day |
| Blood loss | Blood loss characteristics intra- und postoperative | Up to the third postoperative day |
| Fluid balance | Fluid and volume administration and balance intra- und postoperative | Up to the third postoperative day |
| Organ complications | Postoperative organ complications are classified according to Clavien - Dindo classification | Participants will be followed up until hospital discharge, an average of two weeks |
| Postoperative pain | Postoperative pain will be measured by Numeric Rating Scale - Visualized (NRS-V), the Faces Pain Scale - Revised (FPS-R), the Behavioral Pain Scale (BPS) or the Behavioral Pain Scale for Non-Intubated (BPS-NI) | Up to the third postoperative day |
| Hospital length of stay | Participants will be followed up until hospital discharge, an average of two weeks |
| Intensive care unit length of stay | Participants will be followed up until intensive crae unit discharge, an average of two days |
| Quality of life | Assessed with EQ-5D questionnaire | Baseline and hospital discharge with an expected average of 14 days |
| Functional status | Measured by the Barthel activities of daily living (ADL) index and activities of daily living (IADL). | Baseline and hospital discharge with an expected average stay of 14 days |