Influence of Preload Dependence on the Effect of Phenylephrine on Cardiac Output
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Purpose
The perioperative hemodynamic management aims to ensure organ perfusion pressure and an oxygen arterial transport adapted to oxygen consumption. Phenylephrine is the α-adrenergic agonist widely used during anesthesia for arterial pressure control.
Several questions on phenylephrine global and regional hemodynamics effects remain unresolved.
The investigators assume that Phenylephrine may decrease cardiac output by increasing the afterload, while most likely could also make an increase or a stability of cardiac output by action on the venous return. The investigators propose an observational study assessing the influence of preload dependence, defined by the values of pulse pressure variation, on the effect of phenylephrine on cardiac output, measured beat by beat by esophageal Doppler.
The aim of the investigators work is to improve the understanding of phenylephrine action, a daily use therapeutic action, to improve the patients care.
| Condition |
|---|
|
Hypotension |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Influence of Preload Dependence on the Effect of Phenylephrine on Cardiac Output |
- cardiac output [ Time Frame: one year ] [ Designated as safety issue: No ]Comparing cardiac output values before and after injection of a phenylephrine bolus, based on the existence of a preload dependency, defined by a measure of respiratory variation of pulse pressure greater than or equal to 13%.
| Estimated Enrollment: | 40 |
| Study Start Date: | November 2012 |
| Estimated Study Completion Date: | January 2014 |
| Estimated Primary Completion Date: | November 2013 (Final data collection date for primary outcome measure) |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
General anesthesia.Orotracheal intubation and mechanical ventilation Advanced Hemodynamic Monitoring intraoperative ( arterial pressure catheter, esophageal Doppler)
Inclusion Criteria:
- Hypotension (SBP <90 mm Hg and / or MAP <60 mm Hg)
- Injection of a bolus of phenylephrine at the discretion of the anesthesiologist physician in charge of the patient.
Exclusion Criteria:
- Minor or major patient under guardianship
- Esophageal Diseases
- supra ventricular rhythm trouble
- Severe valvular
- Shunt intracardiac
- Vt <7ml/kg theoretical weight
- heart rate / respiratory rate <3.6
- Clinical hypepression of intra-abdominal
- Compliance <30 mL/cmH2O
- pulmonary hypertension, Right ventricular failure
- Spontaneous Ventilation
- Thorax open
- VG severe dysfunction (LVEF <40%)
- Prior Injection of ephedrine prior
Contacts and Locations| Contact: Olivier REBET, M.D | +336111751 | rebet-o@chu-caen.fr |
| Contact: Jean Luc FELLAHI, M.D;Ph.D | fellahi-jl@chu-caen.fr |
| France | |
| CAEN University Hospital | Recruiting |
| Caen, Basse Normandie, France, 1400 | |
| Contact: Olivier REBET, M.D +33611131751 rebet-o@chu-caen.fr | |
| Contact: Jean Luc FELLAHI, M.D;Ph.D fellahi-jl@chu-caen.fr | |
| Principal Investigator: | Olivier REBET, M.D | University Hospital, Caen |
More Information
No publications provided
| Responsible Party: | University Hospital, Caen |
| ClinicalTrials.gov Identifier: | NCT01730820 History of Changes |
| Other Study ID Numbers: | NEO CO, A12-D20-VOL12 |
| Study First Received: | November 16, 2012 |
| Last Updated: | November 20, 2012 |
| Health Authority: | France: Committee for the Protection of Personnes |
Additional relevant MeSH terms:
|
Hypotension Vascular Diseases Cardiovascular Diseases Phenylephrine Oxymetazoline Adrenergic alpha-1 Receptor Agonists Adrenergic alpha-Agonists Adrenergic Agonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
Physiological Effects of Drugs Cardiotonic Agents Cardiovascular Agents Therapeutic Uses Mydriatics Autonomic Agents Peripheral Nervous System Agents Sympathomimetics Vasoconstrictor Agents Nasal Decongestants Respiratory System Agents Protective Agents |
ClinicalTrials.gov processed this record on May 23, 2013