Predictive effect of central venous pressure changes from passive leg elevation in homodynamic stability during anesthesia induction in adult cardiac surgery

Objective: Studying the predictive effect of central venous pressure changes from passive leg elevation in homodynamic stability during anesthesia induction in adult cardiac surgery Design: Prospective randomized clinical trial Setting and conduct: One hundred and twenty adult patients candidate for elective cardiac surgery, randomly will be allocated in two study and control groups (N=60). Using local anesthesia, arterial and central venous catheters placed and invasive arterial and central venous blood pressures will be monitored. Anesthesia will be induced using fentanyl, midazolam and cisatracurium. In study group patients, passive leg elevation (30-45 degrees) maneuver will performed one minute before anesthesia induction and got back to normal position, 12-15 minutes later. In control group anesthesia induction is performed in supine position. Invasive arterial and central venous pressures will be recorded one minute before and after induction, 5, 10 and 20 minutes after tracheal intubation. Hypotension below 100 mmHg will be treated using ephedrine 10 mg. At the end the arterial and central venous blood pressures changes within and between groups will be compared and predictive effect of central venous blood pressures changes after passive leg elevation maneuver on homodynamic stability will be calculated. Inclusion criteria: Patients between 18-70 Years olds who are candidate for elective cardiac surgery Exclusion criteria: Urgent surgery; redo surgery; non-cardiac disease (diabetes, hepatic and renal); Left Ventricular EF less than 40 percent; recent acute MI or unstable angina; systolic arterial blood pressures more than 160 mmHg Intervention: Passive leg elevation maneuver before anesthesia induction Outcome measures: Arterial and central venous blood pressures changes

Vice Chancellor for Research of Tabriz University of Medical Sciences