Oedema

• Research type

  Research Study

• Full title

  Study of changes of mean systemic filling pressure and functional capillary density after stroke volume maximisation in post-operative patients

• IRAS ID

  164918

• Contact name

  H.D. Aya

• Contact email

  hollmann.aya@nhs.net

• Sponsor organisation

  St George's University of London

• Clinicaltrials.gov Identifier

  REC reference number, 14/LO/2047

• Duration of Study in the UK

  0 years, 4 months, 1 days

• Research summary

  The administration of intravenous fluids (IV) is a crucial part of the post-operative care of high-risk surgical patients. However, an excess of fluids can also be harmful. Fluid overload can increase the fluid around the cells (oedema), increasing the distance between microscopic blood vessels (capillaries) and cells. This impairs the oxygen diffusion to the cells and increases the risk of organ failure.
  Currently, fluid therapy is guided by the cardiac function's response to a sequence of small doses of IV fluids given in a short period of time. Fluids are given until the cardiac function is not improving anymore. This is called stroke-volume maximisation. It is currently unknown if this process may generate oedema at the microvascular level.
  Intravascular volume can be measured using the mean systemic filling pressure (Pmsf). Pmsf is like the pressure in a tyre: it depends on the volume inside the tyre and the properties of the tyre wall. Pmsf increase during fluid administration. However, it can increase to a level where the intravascular fluid leaks out of the circulation to the space around the cells (interstitial space) generating oedema. If that were the case, certain level of Pmsf could be used as a safety limit for fluid therapy and avoid fluid overload. This study aims to identify if our current in fluid administration practice is safe at the microcirculatory level and if the Pmsf can be used to improve our current practice.

• REC name

  London - Camden & Kings Cross Research Ethics Committee

• REC reference

  15/LO/0280

• Date of REC Opinion

  9 Apr 2015

• REC opinion

  Further Information Favourable Opinion