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The study aim is to investigate whether preoperative heart failure has impact on hemodynamic stability during anesthesia induction by target controlled infusion of anesthesia (TCI) in non-cardiac, non-morbidly obese surgery.
40 individuals are enrolled to the study after signed informed consent at the day of surgery. The study participants are randomized (non-blinded) to preoperative fluid therapy (preoperative colloid fluid bolus at 6 ml/kg LBW, Gelofusineâ„¢, Fresenius Kabi AB, Sweden) or control (no preoperative fluids) before standardized TCI- induction of anesthesia. No other intravenous fluids before anesthesia induction.
Preoperative screening of biventricular systolic and diastolic function of the heart and level of venous return is implemented by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preoperative echo + fluids | Experimental | 20 individuals investigated by preoperative transthoracic echocardiography. Preoperative colloid fluid bolus (Gelofusine, Fresenius Kabi AB, Sweden) 6 ml/kg lean body weight, is infused intravenously immediately before anesthesia induction. |
|
| Preoperative echo, control | Active Comparator | 20 individuals investigated by preoperative transthoracic echocardiography. No intravenous fluids are infused before anesthesia induction. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative colloid fluid bolus (Gelofusine) | Other | Preoperative colloid fluid bolus |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of blood pressure drops | Blood pressure drop below mean arterial pressure at 65 mmHg during anesthesia induction. Non-invasive blood pressures (systolic, mean and diastolic) are measured 5 minutes before anesthesia induction and thereafter every 5 minutes post-induction . | 20 minutes post anesthesia induction |
| Incidence of severe blood pressure drops | Blood pressure drop below mean arterial pressure at 55 mmHg during anesthesia induction. Non-invasive blood pressures (systolic, mean and diastolic) are measured 5 minutes before anesthesia induction and thereafter every 5 minutes post-induction. | 20 minutes post anesthesia induction |
| Measure | Description | Time Frame |
|---|---|---|
| Venous return and hemodynamic stability | Level of venous return impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg | 20 minutes post anesthesia induction |
| Systolic heart failure and hemodynamic stability |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tomi Myrberg, MD PhD | Umea Universitet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sunderby teaching hospital | Luleå | 97180 | Sweden |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| D000013 | Congenital Abnormalities |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| ID | Term |
|---|---|
| D011097 | Polygeline |
| ID | Term |
|---|---|
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
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A consecutive cohort. Signed informed consent is gathered. Non-blinded randomization is conducted to fluid therapy before anesthesia induction. Preoperative diagnostics by echocardiography is conducted to all participants.Two arms, with or without preoperative fluids, are studied regarding hemodynamic stability during anesthesia induction.
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| Preoperative transthoracic echocardiography | Diagnostic Test | Screening of biventricular systolic and diastolic function of the heart and level of venous return by transthoracic echocardiography approximately one hour before preoperative fluid therapy and anesthesia induction. |
|
Systolic heart failure impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg
| 20 minutes post anesthesia induction |
| Diastolic dysfunction and hemodynamic stability | Diastolic dysfunction impact on blood pressure drops during anesthesia below mean arterial pressure at 65 mmHg | 20 minutes post anesthesia induction |
| D001697 |
| Biomedical and Dental Materials |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |