Using Lung Ultrasound to Guide Blood Flow Management During Major Non-Heart Surgery in Adults

What this Trial Is About

Researchers are evaluating the use of lung ultrasound-guided hemodynamic optimization compared to standard care in adults undergoing major non-cardiac surgery such as abdominal, orthopedic, or vascular surgery. The study aims to reduce postoperative organ failure by improving vascular filling decisions during surgery. This approach addresses concerns that current methods of guiding vascular filling have limitations and no gold standard monitoring device exists for intraoperative use. Participants are randomly assigned to either a control group receiving usual care with noradrenaline and vascular filling guided by stroke volume, or an experimental group where lung ultrasound is used to detect B-lines indicating fluid overload during vascular filling. The intervention group follows an algorithm that includes stopping vascular filling if stroke volume does not increase sufficiently and monitors the appearance of B-lines to avoid fluid overload. This study represents a Phase 3 randomized trial without masking. During the study, patients will be monitored intraoperatively with stroke volume measurements and lung ultrasound scans. Researchers will track postoperative organ failure within 7 days and length of hospital stay. Other evaluations include adherence to the vascular filling protocol and assessment of fluid tolerance. Participants must be followed and assessed throughout surgery and postoperatively to measure outcomes and complications related to hemodynamic management.

Lung Ultrasound-guided Hemodynamic Optimization