Correlation of Estimated Continuous Cardias Output (esCCO) and Picco in Partial Liver Resection

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01443767
Recruitment Status : Completed
First Posted : September 30, 2011
Last Update Posted : February 14, 2012
Nihon Kohden Europe
Information provided by (Responsible Party):
Christoph Schramm, M.D., Heidelberg University

Brief Summary:
The purpose of this study is to determine the measuring accuracy of the truly non-invasive method estimated continuous cardiac output (esCCO) against the reference method pulse contour analysis of the arterial waveform (Picco) in partial liver resection. esCCO is calculated using the pulse wave transit time, which is defined as the time between the R-wave of the ECG and a 30% increase of the differentiated pulseoximetry waveform.

Condition or disease
Continuous Cardiac Output

Detailed Description:

The objective is to compare two methods of cardiac output measurement: the new non-invasive method called esCCO™ (by Nihon Kohden, Tokyo, Japan) and the established more invasive method PiCCO™ (by PULSION Medical Systems, Munich, Germany). esCCO™ is a completely non-invasive method that could provide a cardiac output measurement in a large range of patients because of an extremely low risk benefit balance. Thus the valuable information of cardiac output in combination with standard patient monitoring could be integrated in the assessment and clinical handling of a patients circulatory system.

In previous Japanese studies, esCCO™ was tested against the pulmonary artery catheter in patients undergoing heart surgery. Because of promising results in those studies, the validity of the method is now tested in patients scheduled for partial liver resection as a major visceral surgery intervention. Partial liver resection is a medium to high risk surgical intervention because of the extended blood supply of the organ. High and sudden blood loss can easily occur during the operation. Measurement period starts at the beginning of anesthesiologic induction and is continued until the extubation at the end of the intervention.

The algorithm for esCCO™ -measurement is integrated in an approved patient monitor that replaces the standard patient monitor during the measurement-period. The PiCCO™-device is added on the same rack and a cable connects the PiCCO™-device to the patient monitor. To assure maximum quality of the reference method, a thermodilution for PiCCO™-calibration is accomplished every 30 minutes.

In the study protocol, events like esCCO™ - and PiCCO™-calibration time, catheter positioning time, changes of the patient's position, ventilation settings, volume in- and output and drug administration, patients's data and diagnoses are logged. Vital parameters from the patient monitor including the PiCCO™-cardiac output values are recorded every second in real time on a study laptop mounted on the same rack as the patient monitor and the PiCCO™ device but separated electrically from the other devices.

A total of 30 patients shall be investigated in the study during a planned study time of approximately 6 months. The ethics committee of the University of Heidelberg gave their consent to the study (S-188/2011). The investigators will approximately receive 1080 data pairs when averaging the values every 5 minutes with a mean duration of the surgical procedure of 3 hours.

For statistical analysis, a Bland-Altman-test for multiple values in one patient, a t-test for depending values, correlation graphics and a regression equation will be performed.

Study Type : Observational
Actual Enrollment : 27 participants
Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Pilot Study to Examine the Correlation of 'Estimated Continuous Cardias Output' (esCCO) With Pulse Contour Analysis of the Arterial Waveform (Picco) in Partial Liver Resection
Study Start Date : July 2011
Actual Primary Completion Date : November 2011
Actual Study Completion Date : November 2011

Partial liver resection
Adult patients scheduled for elective partial liver resection

Primary Outcome Measures :
  1. Correlation of esCCO and Picco in Partial Liver Resection [ Time Frame: Intraoperative (Measurement from induction of anaesthesia to extubation) ]

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
adult patients scheduled for partial liver resection

Inclusion Criteria:

  • written consent
  • patient scheduled for partial liver resection
  • sinus rhythm

Exclusion Criteria:

  • no written consent
  • continuous severe cardiac arrhythmias
  • cardiac pacemaker
  • intraaortal balloon pump

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01443767

University of Heidelberg
Heidelberg, Germany, 69120
Sponsors and Collaborators
Heidelberg University
Nihon Kohden Europe
Study Chair: Konstanze Plaschke, Professor Heidelberg University
Principal Investigator: Christoph Schramm, M.D. Heidelberg University

Responsible Party: Christoph Schramm, M.D., Principal Investigator, Heidelberg University Identifier: NCT01443767     History of Changes
Other Study ID Numbers: S188/2011
First Posted: September 30, 2011    Key Record Dates
Last Update Posted: February 14, 2012
Last Verified: February 2012

Keywords provided by Christoph Schramm, M.D., Heidelberg University:
Cardiac Output
Pulse Wave Transit Time
Pulse Contour Analysis
Non-invasive Monitoring
Partial Liver Resection