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Perioperative fluid management is crucial for patients' outcome. Muller et al developed a "Mini-fluid challenge method " to predict fluid responsiveness and the efficacy. The investigators design the study to investigate the effectiveness of mini-fluid challenge test in video assisted thoracic surgery.
Perioperative fluid management is crucial for patients' outcome. Series of studies have indicated that adequate fluid management optimizes the cardiac out put, improves tissue perfusion, thus decrease the risk of postoperative morbidity. Muller et al developed a "Mini-fluid challenge method " to predict fluid responsiveness and the efficacy. Fluid status and proper perfusion condition in patients undergo thoracic surgery are especially crucial for the vulnerability of lung toward fluid overload. To the best of our knowledge, the efficacy of the test was not discussed in the perioperative care in video assisted thoracic surgery. The investigators design the study to investigate the effectiveness of mini-fluid challenge test in video assisted thoracic surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intubated group | Experimental | Patient in this group will receive general anesthesia with endotracheal tube intubation to perform one lung ventilation. Patient will be paralyzed and controlled ventilation will be implied. |
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| Non-intubated group | Experimental | Patient in this group will receive general anesthesia with laryngeal mask insertion. Patients in this group will not be paralyzed and keep spontaneous breathing to maintain one lung ventilation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Crystalloid Solutions | Drug | Mini-fluid challenge with crystalloid 250 ml will be given to patients first. After observation of hemodynamic parameters, further fluid challenge will be given for response observation. |
| Measure | Description | Time Frame |
|---|---|---|
| Change of blood pressure after fluid loading | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Change of cardiac index after fluid loading | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| Measure | Description | Time Frame |
|---|---|---|
| stroke volume variation(SVV) | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| stroke volume (SV) | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge |
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Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tzu Jung Wei | Contact | +886972653416 | sa46222@gmail.com | |
| National Taiwan University Hospital | Contact |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Recruiting | Taipei | 100 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22617510 | Background | Evans RG, Naidu B. Does a conservative fluid management strategy in the perioperative management of lung resection patients reduce the risk of acute lung injury? Interact Cardiovasc Thorac Surg. 2012 Sep;15(3):498-504. doi: 10.1093/icvts/ivs175. Epub 2012 May 22. | |
| 18212731 | Background | Cavallaro F, Sandroni C, Antonelli M. Functional hemodynamic monitoring and dynamic indices of fluid responsiveness. Minerva Anestesiol. 2008 Apr;74(4):123-35. Epub 2008 Jan 24. |
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| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| ID | Term |
|---|---|
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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| 3 hours |
| stroke volume index(SVI) | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| plethysmographic variation index(PVI) | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| pulse pressure variation(PPV) | Interpretate the correlation of mini-fluid challenge and conventional fluid challenge | 3 hours |
| 21792055 | Background | Vincent JL. "Let's give some fluid and see what happens" versus the "mini-fluid challenge". Anesthesiology. 2011 Sep;115(3):455-6. doi: 10.1097/ALN.0b013e318229a521. No abstract available. |
| 20477782 | Background | Wyffels PA, Sergeant P, Wouters PF. The value of pulse pressure and stroke volume variation as predictors of fluid responsiveness during open chest surgery. Anaesthesia. 2010 Jul;65(7):704-9. doi: 10.1111/j.1365-2044.2010.06371.x. Epub 2010 May 6. |