Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Intraoperative hypotension is closely related to the poor prognosis of surgery. The study is focused on the effectiveness of maintaining normal peripheral perfusion index (PPI) on time-weighted average of hypotension during anesthesia.
Intraoperative hypotension is closely related to the poor prognosis of surgery. Hypotension decreased blood flow perfusion of organs, which lead to dysfunction of multiple organs, especially increasing serious complications such as cardio-cerebrovascular events and acute renal injury within 30 days after surgery. The aim of this study is to establish a set of strategies that can effectively prevent and treat intraoperative hypotension, so as to alleviate possible harm to patients from perioperative hypotension. The study is focused on the effectiveness of maintaining normal peripheral perfusion index (PPI) on time-weighted average of hypotension during anesthesia. The lower target mean arterial pressure (MAP) was higher than 65 mmHg. MAP less than 65 mmHg was defined as intraoperative hypotension between induction and tracheal extubation.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PPI guided strategies | Experimental | The decision making for prevention and treatment of hypotension was PPI guided to maintain the PPI between 1 and 3. |
|
| conventional strategies | Other | The decision making for prevention and treatment of hypotension dependent on the experience of anesthesiologist. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PPI guided strategies | Behavioral | For targeted MAP or lower, if PPI<1, more fluid therapy. if PPI>3, vasoconstriction therapy. For MAP<65mmHg and 1<=PPI<3, test bolus of 250 ml crystalloid fluid. |
| Measure | Description | Time Frame |
|---|---|---|
| time-weighted average of hypotension (TWA)<65mmHg | total area under MAP<65 mmHg/surgery length | Intraoperative (between anesthesia induction and tracheal extubation) |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of hypotension after anesthesia induction | the number of participants of hypotension/ the number of each group | from anesthesia induction to 15 minutes after then |
| Cumulative number of intraoperative hypotension episodes |
Not provided
Inclusion Criteria:
65 years and older ASA Physical Status 1-3 general anesthesia arterial catheterization procedures last more than 2 hours communicate normally in Mandarin
Exclusion Criteria:
abnormal Allen's test higher target than 65 mmHg history of diabetes vascular diseases arrhythmia cardiac function class II and above physical disability, unable to conduct PPI monitoring participated in other clinical studies in the past month
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhiqiang Zhou, Dr. | Contact | 862783663173 | zqzhou@tjh.tjmu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Zhiqiang Zhou | Tongji Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhiqiang Zhou | Recruiting | Wuhan | 430030 | China |
Not provided
Not provided
Not provided
Not provided
Not provided
| Empirical strategies | Behavioral | Fluid therapy or vasoconstriction depended on experiences of anesthetic staffs. |
|
Cumulative number of MAP<65mmHg and last at least for three minutes
| Intraoperative (between anesthesia induction and tracheal extubation) |
| Cumulative time of intraoperative hypotension period | Cumulative time of MAP<65mmHg | Intraoperative (between anesthesia induction and tracheal extubation) |
| Proportion of time with hypotension | Proportion of cumulative time of intraoperative hypotension period and the anesthesia time | Intraoperative (between anesthesia induction and tracheal extubation) |
| time-weighted average of hypertension (TWA)>100mmHg | total area under MAP>100 mmHg/surgery length | Intraoperative (between anesthesia induction and tracheal extubation) |
| Cumulative number of intraoperative hypertension episodes | Cumulative number of MAP>100 mmHg and last at least for three minutes | Intraoperative (between anesthesia induction and tracheal extubation) |
| postoperative plasma concentration of lactic acid | Plasma concentration of lactic acid in the end of surgery | 5 minutes before and 5 minutes after the end of surgery |
| arterial partial pressure of oxygen (PaO2)/inspired fraction of oxygen (FiO2) | PaO2/FiO2 | 5 minutes before and 5 minutes after the end of surgery |
| intraoperative urine output | urine output during the surgery | Intraoperative (between anesthesia induction and tracheal extubation) |
| the rate of acute kidney injury (AKI) | the number of participants with AKI/ the number of each group | within 7 days after the end of surgery |