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Pre-surgery heart ultrasound to guide fluid levels before anesthesia

Tests a heart ultrasound before surgery in adults to guide fluid levels during anesthesia.

Plain-language title generated from the registry record
Registry title: Preoperative Blood Volume Optimization Using Transthoracic Echocardiography

Key facts

Where
Caen, FranceSee the site

Could this be for you?

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

  • Are you between 18 and 99 years old?

Source: NCT06639737, who can take part

Where in France

  • Universty Hospital of CaenCaen, FranceTaking people

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?
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Trial details

Who runs it
University Hospital, Caen
Trial code
NCT06639737
Record updated
15 October 2024
Original description
Immediately following the induction of general anesthesia, arterial hypotension may occur with an incidence of about 40% in patients classified as ASA 3 or 4. Perioperative arterial hypotension is associated with increased perioperative morbidity and mortality. The increased mortality associated with perioperative arterial hypotension has been reported up to 30 and 90 days after surgery. This association appears to be both dose-dependent and time-dependent (severity and duration of arterial hypotension).Read full original descriptionShow less

Effect of Preoperative Stroke Volume Optimization Using Transthoracic Echocardiography on Arterial Hypotension Following Induction of Intravenous Anesthesia. A Prospective, Double Blinded Randomized Study.

Immediately following the induction of general anesthesia, arterial hypotension may occur with an incidence of about 40% in patients classified as ASA 3 or 4. Perioperative arterial hypotension is associated with increased perioperative morbidity and mortality. The increased mortality associated with perioperative arterial hypotension has been reported up to 30 and 90 days after surgery. This association appears to be both dose-dependent and time-dependent (severity and duration of arterial hypotension).

EchOptimal study aims to determine whether non invasive preoperative stroke volume optimization using transthoracic echocardiography (TTE) can reduce the incidence and severity arterial hypotension following induction of general anesthesia.

This is prospective, randomized, controlled, double blinded study approved by ethics comittee.

The primary objective of this study is to compare the incidence of arterial hypotension (mean arterial pressure < 65 mmHg) within the first 15 minutes following the induction of general anesthesia, between 2 groups :

* standard current care (stroke volume optimized after induction of general anesthesia using oesophageal doppler) and * preopertaive stroke volume optimization using transthoracic echocardiography measument of subaortic velocity time integral.

Inclusion: Patient aged 18 years or older,; Affiliated with social security,; Informed about the study and having signed the informed consent form,; Requires surgical intervention under general anesthesia,; Intermediate or high risk of cardiovascular events within 30 days,; ASA phyiscal status Classification 3 or 4.

Exclusion: Patients not fasting at the time of surgery,; Patients with an immediate life-threatening emergency or requiring surgery without delay to ensure survival,; Patients receiving aminergic support before anesthetic induction,; Patients treated with ACE inhibitors/ARBs who have not discontinued the treatment on the day of the procedure; Patients with contraindications for placing an arterial pressure catheter in the radial artery: bilateral negative Allen's test indicating absence of ulnar collateral circulation, Raynaud's syndrome, Buerger's disease, severe dyslipidemias,; Patients with characteristics making the measurement of ITVSAo uninterpretable: atrial fibrillation, non-sinus electrocardiogram, severe valvulopathy, documented right or left heart failure,; Pregnant or breastfeeding women,; Patients under guardianship, curatorship, judicial protection, or legal protection,; Minors,; Patients with contraindications to intravenous induction with Propofol and Remifentanil,; Patients under general anesthesia before arrival in the operating room,; Patients requiring rapid sequence induction,.

ClinicalTrials.gov NCT06639737