Anesthesia, GeneralNCT03718949
Can Continuous Cardiac Output Monitoring Before General Anesthesia Predict Hypotension After Induction?
An observational study of Anesthesia, General and Hypotension, run by National Taiwan University Hospital at 1 site in Taiwan.
Trial summary
Post-induction hypotension (PIH) is very common with high incidence about 9-60%. There are multiple factors that may cause PIH, like pre-operative fasting, bowel preparation, vasodilatation due to anesthetics, and reduced stimulation during preparation before incision. Read more about this study
- Who is it for?
- Ages 20 to 99 yearsHealthy volunteers can take part
- Conditions the study is for
- Anesthesia, General, Hypotension, Cardiac Output
- How many people
- 80 participants
- Where
- 1 siteTaiwan
- Study dates
- 4 Dec 2018to 31 Dec 2019
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 99 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: patients older than 20 years old, and accept major surgery
- >20 years old
- American Society of Anesthesiologists Classification(ASA) I~III
- patients accept major surgery under general anesthesia, and monitored with invasive arterial blood pressure and estimated cardiac output.
Trial locations and contacts
1 site in 1 country.
Taiwan1 site, 1 recruiting
- Recruiting
National Taiwan University Hospital
Taipei, 100
Ying-Tzu Li, MD, 0972651903, B94401037@ntu.edu.tw
About this study
Post-induction hypotension (PIH) is very common with high incidence about 9-60%. There are multiple factors that may cause PIH, like pre-operative fasting, bowel preparation, vasodilatation due to anesthetics, and reduced stimulation during preparation before incision. Hypotension could cause tissue hypoperfusion, ischemia and higher risk for stroke or myocardial infarction, which result in higher risk for prolonged hospital stay or death. In general surgical patients, lower pre-induction SAP, older age (>50 years old), and emergency surgery are independently associated with PIH. In this study, we would like to use a wireless continuous non-invasive sonography device to evaluate if the change of cardiac output during the perioperative period could predict PIH.
Ｗe would like to enroll 80 patients of ASA class I to III who undergo abdominal surgery. GIS-Heartio® will be used to estimate the cardiac parameters one day before the surgery (Day 0) and after the patient enter the operation room till wound incision. Passive leg raise test would be performed on day 0 and before induction. We will analyze the patient's demographic data and the cardiac parameters to see if continuous cardiac output monitor can predict the occurrence of PIH.
Read the detailed description
Post-induction hypotension (PIH) is very common with high incidence about 9-60% in every kind of surgeries includes general anesthesia and neuraxial anesthesia. There are multiple factors that may cause PIH, like pre-operative fasting, bowel preparation, vasodilatation due to anesthetics, sympathetic blockade and reduced stimulation during preparation before surgical incision. Hypotension during the surgeries could possibly cause tissue hypoperfusion, tissue ischemia and higher risk for acute kidney failure, stroke or myocardial infarction, which result in higher risk for prolonged hospital stay or death [1-4]. In general surgical patients, lower pre-induction systolic arterial pressure, older age (>50 years old), and emergent surgery are independently associated with PIH[1].
However, nowadays heart rate variability (HRV), the inferior vena cava(IVC) ultrasound, and stroke volume variation were demonstrated to be able to predict the PIH event [5-7]. However, people with any kind of arrhythmia is not suitable for HRV analysis. Part of obese patients are not suitable for IVC ultrasound due to poor image quality. Stroke volume variation can only be monitored if the arterial catheter and Flotrac® were applied on the patient before anesthetic induction.
In this study, the wireless continuous non-invasive sonography device has the benefits of light-weighted, short learning curve, non-invasive, continuous monitoring, and more intuitive collected data. It's a huge progress for non-invasive cardiac output during anesthesia with GIS-Heartio®. The primary endpoint is if the change of cardiac output after fasting could predict PIH. The second endpoint is whether the change of cardiac output during "passive leg test" could predict PIH. If PIH can be predicted and prevented before anesthesia, the safety of the surgery and prognosis of patient will be elevated!
- Conditions
- Anesthesia, General, Hypotension, Cardiac Output
- Keywords
- pre-operative fasting, general anesthesia, cardiac output,Ultrasonography, Ultrasonography
- Medical subject headings
- Hypotension
What is being measured
The primary outcome is the main question the study is designed to answer.
post-induction hypotension
mean arterial blood pressure 30% lower than baseline, or mean arterial blood pressure <60mmHg
Measured: 20 minutes after induction
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Oct 2018
- Study start4 Dec 2018
- Primary completion31 Dec 2019 (estimated)
- Study completion31 Dec 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Anesthesia, GeneralStudies of the same condition, open and under way.
- More trials run by National Taiwan University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Taiwan University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ying-Tzu Li, MD, Principal investigator, National Taiwan University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03718949
- Sponsor's protocol ID
- 201807139DIPB
- Status last verified
- Oct 2018
- First submitted
- 23 Oct 2018
- Last updated
- 12 Dec 2018
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Dec 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Can Continuous Cardiac Output Monitoring Before General Anesthesia Predict Hypotension After Induction?
- ClinicalTrials.gov ID
- NCT03718949
- Acronym / sponsor ID
- 201807139DIPB
- Conditions
- Anesthesia, General, Hypotension, Cardiac Output
- Keywords
- pre-operative fasting, general anesthesia, cardiac output,Ultrasonography, Ultrasonography
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- National Taiwan University HospitalUniversity, hospital or other
- Study start
- 4 Dec 2018 (actual)
- Primary completion
- 31 Dec 2019 (estimated)
- Study completion
- 31 Dec 2019 (estimated)
- First posted
- 25 Oct 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Post-induction hypotension (PIH) is very common with high incidence about 9-60%. There are multiple factors that may cause PIH, like pre-operative fasting, bowel preparation, vasodilatation due to anesthetics, and reduced stimulation during preparation before incision. Hypotension could cause tissue hypoperfusion, ischemia and higher risk for stroke or myocardial infarction, which result in higher risk for prolonged hospital stay or death. In general surgical patients, lower pre-induction SAP, older age (>50 years old), and emergency surgery are independently associated with PIH. In this study, we would like to use a wireless continuous non-invasive sonography device to evaluate if the change of cardiac output during the perioperative period could predict PIH.
Ｗe would like to enroll 80 patients of ASA class I to III who undergo abdominal surgery. GIS-Heartio® will be used to estimate the cardiac parameters one day before the surgery (Day 0) and after the patient enter the operation room till wound incision. Passive leg raise test would be performed on day 0 and before induction. We will analyze the patient's demographic data and the cardiac parameters to see if continuous cardiac output monitor can predict the occurrence of PIH.
Detailed description
Post-induction hypotension (PIH) is very common with high incidence about 9-60% in every kind of surgeries includes general anesthesia and neuraxial anesthesia. There are multiple factors that may cause PIH, like pre-operative fasting, bowel preparation, vasodilatation due to anesthetics, sympathetic blockade and reduced stimulation during preparation before surgical incision. Hypotension during the surgeries could possibly cause tissue hypoperfusion, tissue ischemia and higher risk for acute kidney failure, stroke or myocardial infarction, which result in higher risk for prolonged hospital stay or death [1-4]. In general surgical patients, lower pre-induction systolic arterial pressure, older age (>50 years old), and emergent surgery are independently associated with PIH[1].
However, nowadays heart rate variability (HRV), the inferior vena cava(IVC) ultrasound, and stroke volume variation were demonstrated to be able to predict the PIH event [5-7]. However, people with any kind of arrhythmia is not suitable for HRV analysis. Part of obese patients are not suitable for IVC ultrasound due to poor image quality. Stroke volume variation can only be monitored if the arterial catheter and Flotrac® were applied on the patient before anesthetic induction.
In this study, the wireless continuous non-invasive sonography device has the benefits of light-weighted, short learning curve, non-invasive, continuous monitoring, and more intuitive collected data. It's a huge progress for non-invasive cardiac output during anesthesia with GIS-Heartio®. The primary endpoint is if the change of cardiac output after fasting could predict PIH. The second endpoint is whether the change of cardiac output during "passive leg test" could predict PIH. If PIH can be predicted and prevented before anesthesia, the safety of the surgery and prognosis of patient will be elevated!
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 20 to 99 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- patients older than 20 years old, and accept major surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
post-induction hypotension
Time frame: 20 minutes after induction
mean arterial blood pressure 30% lower than baseline, or mean arterial blood pressure <60mmHg
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Dec 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ying-Tzu Li, MD principal investigator
National Taiwan University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Anesthesia, General and Hypotension, run by National Taiwan University Hospital at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 12 Dec 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Ying-Tzu Li (0972651903, B94401037@ntu.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
post-induction hypotension (time frame: 20 minutes after induction). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Dec 2018; AzTrials last refreshed its copy on 7 Nov 2026.