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In a recent study (Vignon 2017), respiratory variations of the diameter of superior vena cava had a greater diagnostic accuracy than pulse pressure variations and inferior vena cava respiratory variations in 540 medical and surgical ICU patients. But this indicator has not been investigated yet in cardiac surgery. The investigator aim to study respiratory variations of superior vena cava for predicting fluid responsiveness after cardiac surgery.
In post-operative cardiac surgery patients with hemodynamic failure, the investigator will measure respiratory vena caval variations with TEE (Trans oesophageal echocardiography). Then, the investigator will evaluate fluid responsiveness after a fluid challenge (Trendelenburg).
A ROC curve will be constructed in order to assess the optimal sensitivity and specificity of this parameter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hemodynamic instability with hypotension |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trans oesophageal echocardiography | Other | Transoesophageal echocardiography : it's a standard practice for this patient |
|
| Measure | Description | Time Frame |
|---|---|---|
| diameter of vena cava superior | measured with trans oesophageal echocardiography | at 6 post-operative hours |
| Measure | Description | Time Frame |
|---|---|---|
| % of respiratory variations of maximal Doppler velocity in left ventricular outflow tract | measured with trans oesophageal echocardiography | at 6 post-operative hours |
| % of respiratory variations of maximal Doppler velocity in pulmonary artery |
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Inclusion Criteria:
Exclusion Criteria:
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patients with hemodynamic instability and hypotension
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| Name | Affiliation | Role |
|---|---|---|
| Olivier PEYROUSET, MD | Centre Hospitalier Universitaire de Saint Etienne | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire de Saint Etienne | Saint-Etienne | 42055 | France |
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| Trendelenburg test | Other | Trendelenburg test : it's a standard practice for this patient |
|
measured with trans oesophageal echocardiography
| at 6 post-operative hours |
| % of pulse pressure respiratory variations | measured with trans oesophageal echocardiography | at 6 post-operative hours |