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Pressure Recording Analytical Method Parameters and Their Relationship With Hypotension in Hypertensive Patients

Recruitingn/aAges 18 Years - anyAllRecep Tayyip Erdogan University
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In plain words

What the trial is, and whether it could suit you

Perioperative anesthesiologists can benefit from easily obtainable hemodynamic variables detecting or quantifying the lack of an adequate compensatory capacity of the cardiovascular system in order to optimize patient management and improve patient outcomes. Parameters of the Pressure Recording Analytical Method (PRAM; Vygon, Padua, Italy) of the MostCare system, specifically cardiac cycle efficiency has been proposed as such variables. Yet, their value in anesthesia and especially in hypertensive patients is not studied. The goal of the PRAM-in-HYPO study is to prospectively evaluate the relationship between cardiac reserve and efficiency and cardiovascular risk factors in patients wo will undergo major surgical procedures using the state-of-the-art hemodynamic monitors. Also the investigators aim to build a predictive model to identify patients with decreased cardiac reserve due to hyp

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age at least 18 years * Undergoing major surgery under general anesthesia * Expected surgery time \>2 h * Expected length of postoperative stay \>2 d * Invasive blood pressure (radial or femoral) and Mostcare monitoring * Indication for a passive leg raising test: risk of hypovolemia (preoperative fasting, bowel preparation, loss of appetite, limited access to water) or expected major surgery, expected blood loss, cardiovascular comorbidity (hypertension, diabetes mellitus, coronary artery disease, peripheral artery disease, hyperlipidemia, morbidity, active smoking). * Recruitment after booking for surgery with sufficient time to read, understand and question study patient information prior to attending for surgery. * Ability and willingness to provide informed consent Exclusion Criteria: * Refuse to consent to the study * Arterial wave form distortion * Cardiac arrhythmia * Inappropriate identification of the dicrotic notch for any reason * Planned intraoperative mean arterial blood pressure \< 65 mmHg * Hemodynamic instability defined as mean arterial blood pressure \< 65 mmHg * Preoperative requirement of inotrope/vasopressor infusion * Preoperatively receiving vasoactive drugs * Patients fitted with an intra-aortic balloon pump * Patients fitted with Extracorporeal Membrane Oxygenation * Critically ill patients requiring preoperative intensive care unit * Presence of intraabdominal hypertension * New York Heart Association Class 3-4 heart failure * Congestive heart failure with ejection fraction \< 35% * Glomerular filtration rate \< 30 ml/min/1.73 m2 * Ongoing renal replacement therapy
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What it tests

  • Passive leg raising
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Where

5 sites
Gazi University Medical Faculty, Department of Anesthesiology and Reanimation
Ankara, Turkey (Türkiye)
Erzurum Atatürk University Medical Faculty, Department of Anesthesiology and Reanimation
Erzurum, Turkey (Türkiye)
Başakşehir Çam ve Sakura City Hospital, University Medical Faculty, Anesthesiology and Reanimation Clinic
Istanbul, Turkey (Türkiye)
Acıbadem University Medical Faculty, Department of Anesthesiology and Reanimation
Istanbul, Turkey (Türkiye)
Recep Tayyip Erdogan University Medical Faculty, Department of Anesthesiology and Reanimation
Rize, Turkey (Türkiye)
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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