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Clinical assessment of bleeding and calculation of perioperative blood loss do not provide an accurate estimate of blood volume. This makes rational fluid management difficult, which is of high importance for patient-related outcomes. The availability of carbon monoxide(CO)-rebreathing allows for simple, non-invasive and precise measurement of changes in blood volume.
The purpose of the study is to investigate and describe changes in blood volume and fluid distribution perioperative in patients undergoing total hip arthroplasty. Furthermore, to investigate the association between changes in blood volume and incidence of orthostatic insufficiency.
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| Measure | Description | Time Frame |
|---|---|---|
| Change in total blood volume (TBV) | Measured in milliliter (mL) | Preoperatively and 6 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Change in total blood volume (TBV) | measured in mL | Preoperatively and 24 hours postoperatively |
| Changes in total hemoglobin mass (tHgb) | Measured in gram (g) |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperativ estimation of bleeding | Measured by weighting gauze (gram) | Intraoperative at end of the surgical procedure |
| Intraoperative bleeding | Measured by visual estimation in surgical drains (mL) |
Inclusion Criteria:
Exclusion Criteria:
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Patients scheduled for an elective total hip arthoplasty (THA) at Hvidovre University Hospital and undergo the proceduce under spinal anesthesia with propofol sedation.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Puk Kristiansen, MD | Contact | +4530291189 | puk.kristiansen@regionh.dk | |
| Ana-Marija Hristovska, Senior registrar, Ph.D. | Contact | ana-marija.hristovska.02@regionh.dk |
| Name | Affiliation | Role |
|---|---|---|
| Nicolai Foss, Professor, Dr. Med. | Department of Anesthesiology and Intensive Care Medicine, Copenhagen University Hospital, Hvidovre | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hvidovre University Hospital | Recruiting | Copenhagen | 2960 | Denmark |
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| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in erythrocyte volume (EBV) | Measured in mL | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in plasma volume (PV) | Measured in mL | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in hematokrit (Ht) | Reported as percentage(%) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in hemoglobin (Hg) concentration | Measured in millimoles/liter(mmol/L) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in Total body water(TBW), intra-(ICF) and extracellular(ECF) fluid distribution | Full body water via bioelectrical impedance analysis. The individual components are reported in L and percent. | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Changes in C-Reactive Protein (CRP) | Measured in milligram/liter (mg/L) | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Incidence of orthostatic intolerance during mobilization | Symptoms of orthostatic intolerance: dizziness, nausea, vomiting, blurry vision or syncope during mobilization | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Association between total blood loss and incidence of orthostatic intolerance | Blood loss measured in mL. Symptoms of orthostatic intolerance: dizziness, nausea, vomiting, blurry vision or syncope during mobilization | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Association between changes in C-Reactive Protein and total blood loss | C-Reactive Protein measured in mg/L and total blood loss measured in mL | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Association between peripheral perfusion index and total blood loss | Peripheral perfusion index measured in percent and total blood loss in mL | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Association between total hemoglobin (SpHb) and total blood loss | SpHb measured as gram/deciliter and total blood loss measured in mL | Preoperatively, 6 hours postoperatively and 24 hours postoperatively |
| Intraoperative at end of the surgical procedure |