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Structured Hemodynamic Assessment to Guide Care After Cardiac Surgery
Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Summary
This multicenter pilot randomized controlled trial will evaluate whether providing treating physicians with a structured hemodynamic assessment influences care after cardiac surgery. The assessment combines point-of-care ultrasound, including the Venous Excess UltraSound (VExUS) score to assess fluid tolerance, with monitoring using the Swan-Ganz IQ catheter and HemoSphere Alta system to assess fluid responsiveness. Participants will be randomized to a structured hemodynamic assessment strategy or standard care. In the intervention group, treating physicians will receive a report of the structured assessment findings upon admission to the intensive care unit and on postoperative day 1. The co-primary objectives are to evaluate the impact of the structured assessment on treating physicians' management plans and to assess the feasibility of completing the study procedures and delivering assessment reports within the predefined time frame. Secondary and exploratory objectives include evaluating fluid balance, diuretic use, inotropic support, inhaled pulmonary vasodilator use, kidney function, and postoperative clinical outcomes. Exploratory analyses will also examine ultrasound measures of fluid responsiveness in relation to Swan-Ganz IQ measurements and the relationship between right ventricular pressure patterns and venous congestion.
Official title: Using Structured Expert Consultation to Guide Fluid Optimization and Hemodynamic Recommendations After Cardiac surgEry: A Pilot Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
75
Start Date
2026-10-01
Completion Date
2027-10-01
Last Updated
2026-10-20
Healthy Volunteers
No
Interventions
Expert Report of a Structured Hemodynamic Assessment
A structured hemodynamic assessment combining point-of-care ultrasound to assess fluid tolerance using the Venous Excess UltraSound (VExUS) score and Swan-Ganz IQ/HemoSphere Alta monitoring to assess fluid responsiveness during passive leg raising. Assessments are performed at ICU admission and on postoperative day 1. In the intervention group, an expert-reviewed report is provided to the treating team within two hours of each assessment, including findings, relevant contextual interpretation, and non-prescriptive therapeutic considerations. All treatment decisions remain at the discretion of the treating team.
Standard Care (in control arm)
Standard postoperative fluid and hemodynamic management. Participants undergo the same structured hemodynamic assessment, but findings are not disclosed to the treating team unless necessary to protect participant safety.
Locations (2)
Montreal Heart Institute
Montreal, Quebec, Canada
Centre hospitalier de l'Université de Montréal (CHUM)
Montreal, Quebec, Canada