The goal of this observational study is to learn whether atrial pacing-induced preload variation can identify fluid responsiveness in adult patients admitted to the intensive care unit after cardiac surgery.
The main questions it aims to answer are:
Can beat-to-beat atrial pacing induce measurable changes in stroke volume that predict fluid responsiveness? Do stroke volume changes measured by transthoracic echocardiography (LVOT VTI) and arterial waveform analysis identify patients who respond to a 500 mL fluid bolus?
Researchers will compare fluid responders and non-responders, defined by a ≥10% increase in stroke volume after a 500 mL Ringer's lactate fluid bolus, to determine whether pacing-induced hemodynamic changes predict fluid responsiveness.
Participants will:
Undergo a standardized atrial pacing protocol (80-120 bpm in 10 bpm increments) before and after a routine 500 mL Ringer's lactate fluid bolus.
Undergo transthoracic echocardiography and continuous arterial pressure monitoring during the pacing protocol.
Have routine ICU hemodynamic data collected during their admission.
Inclusion Criteria:
Exclusion Criteria:
rob.driessen@mumc.nl+31653821055
No therapeutic intervention will take place. A pacemaker wire is routinely placed by the cardiac surgeon after the surgery, as part of the standard care that occurs with every surgery. As part of the study protocol, an atrial pacing protocol is performed, starting with pacing at 80 bpm, then increasing by 10 beats per minute until reaching 120 bpm, followed by a gradual decrease back to 80 bpm. This protocol is repeated after the administration of the 500 mL fluid bolus.
bas.van.bussel@mumc.nl
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