Comparison of Mean Arterial Pressure- and Cardiac Index-Based Intraoperative Hemodynamic Management on Postoperative Renal Function in Pancreaticoduodenectomy A Prospective Randomized Study

What this Trial Is About

Researchers are comparing two methods of managing blood flow during pancreaticoduodenectomy, a major surgery known as the Whipple procedure. The study evaluates whether managing blood pressure by mean arterial pressure or by cardiac index better supports kidney function shortly after surgery. This prospective randomized study focuses on changes in kidney function, measured by serum creatinine levels, within the first 72 hours after the operation. Participants will be randomly assigned to one of two groups during surgery. One group will have their blood flow managed by keeping mean arterial pressure within target ranges, guiding fluid and medication use accordingly. The other group will have management based on cardiac index targets, adjusting fluids, vasopressors, and inotropes to maintain adequate circulatory status. Both groups receive standard anesthesia care during the pancreaticoduodenectomy. Throughout the study, researchers will monitor kidney function by measuring serum creatinine before surgery and at several points after, including 6, 24, 48, and 72 hours post-operation. They will also track urine output, fluid given during surgery, medication use, and hospital recovery details such as intensive care and total hospital stay lengths. The study aims to understand which management method better preserves kidney function after this complex surgery, with participants involved from surgery through early recovery assessments.

MAP- Versus Cardiac Index-Guided Hemodynamic Management in Whipple Surgery