Patient will be "nil per os" from midnight before their cesarean section

Patient will receive 400 mL of Nutricia Preop ® 2 hours before their cesarean section

Anesthesia, Spinal

Cesarean Section

Oral rehydration 2 hours before the scheduled cesarean section under spinal anesthesia

Nutricia PreOp

Post Spinal Anesthesia Hypotension and Preoperative Hydration

Impact of Preoperative Oral Rehydration on the Incidence of Spinal Anesthesia-induced Hypotension for Scheduled Cesarean Section.

We aim for a 50% reduction in the incidence of hypotension following spinal anesthesia for scheduled C-section.

Patients' satisfaction measured by a questionary

Denis SCHMARTZ

Head of department, anesthesiology

Brugmann University Hospital

this arm will recieve PEG3350 in addition to standard of care

this arm will recieve only standard of care for management of hepatic encephlaopathy with ACLF

Hepatic Encephalopathy

Acute-On-Chronic Liver Failure

experimental arm will receive 2 doses of PEG3350 spaced over 12 hours after randomization to arm1. PEG as dose of 2litres (1 sachet dissolved in 2L of water) will be administered via a nasogastric tube.

PEG-3350 with Electolytes

Lactulose will be given orally (30ml QID) which shall be titrated to ensure 2-3 soft stools per day

Lactulose

Postgraduate Institute of Medical Education and Research

PEG3350 in ACLF With Hepatic Encephalopathy

Therapeutic Efficacy of Oral PEG3350 Plus Lactulose Versus Lactulose Alone in Patients of Acute on Chronic Liver Failure With Overt Hepatic Encephalopathy: A Single Blind Prospective Randomized Controlled Study

to look for any survival benefit in experimental arm at 28 days and 90 days

to look for the degree of improvement in grade of HE in both experimental arm and lactulose arm.

to extrapolate weather reduction of grade of HE correlates with reduction of ammonia levels

to analyse the difference in time to event(death) among non survivors in experimental arm

to look for any evidence of cerebral edema reduction by means of optic nerve sheath diameter

to analyse if reduction of HEresults in reduction or prevention of seizure episodes in both arms

Radha K Dhiman

Professor

participant is randomised using a table of random numbers.

patients with postural orthostatic tachycardia syndrome diagnosis.

Patients with Postural orthostatic tachycardia syndrome who has peripheral neuropathy

Whole blood will be retain for DNA extraction.

Postural Tachycardia Syndrome

Oral glucose tolerance test

Vanderbilt University Medical Center

Gastrointestinal Symptoms in Postural Orthostatic Tachycardia Syndrome

POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME AND GASTROINTESTINAL SYMPTOMS: Contribution of Gastrointestinal Peptides

The plasma levels of GI peptides (GLP-1, GLP-2, PPY, glucagon, C-peptide, insulin) and their pattern of secretion after ingestion of 75 g glucose.

Gastric emptying time will be measured by acetaminophen absorption test after ingestion of 75 grams glucose.

The gastrointestinal symptoms will be evaluated by questionnaire after ingestion of 75 grams glucose.

Symptoms related to postural orthostatic tachycardia symptoms will be evaluated by specific questionnaire after ingestion of 75 grams glucose.

Cyndya Shibao

Assistant Professor

Patients undergoing major elective thoracic and abdominal, the latter group including upper gastrointestinal, esophageal, and colorectal procedures. In this group FR will predicted by administering a fluid challenge of 250 ml of Lactated Ringer's solution and measuring SV with the ccNexfin

Actual Impaired Fluid Volume

When VE is prescribed to a patient, a fluid challenge of 250mL Lactated Ringer's solution will first be administered. The ccNexfin system will be used to predict FR (SV increases by at least 15% in response to a fluid challenge). The remaining amount of fluid ordered by the treating team will then be administered, and SV will again be measured.
Additionally, a daily fluid challenge with 250mL of Lactated Ringer's will also be administered, with FR recorded as above

Fluid challenge (250 ml Lactated Ringer's solution)

Fluid Responsiveness in the Postoperative Patient: a Prospective Study

FR (SV increases by ≥ 15% ) FR will be measured 1 minute after the completion of VE

The probability of being fluid responsive after VE will be tested before initiating VE by administering a fluid challenge of 250 ml of Lactated Ringer's. The patient will be considered fluid responder to the fluid challenge if SV increases by ≥ 15% 1 minute after the infusion

FR (SV increases by ≥ 15% ) FR will be measured 1 and 5 minutes after the completion of the fluid challenge of 250 ml of Lactated Ringer's.

Ratio between Pulse Pressure Variation (PPV,%) and Stroke Volume Variation (SVV,%)

Postoperative complications will be defined a priori and classified based on Clavien Classification

Elapsed time (days) between surgical admission (same day of surgery) and the achievement of hospital discharge criteria

Elapsed time (days) between surgical admission (same day of surgery) and primary hospital discharge. The day of surgery is count as postoperative day 0

Any clinical indication or laboratory abnormality triggering volume expansion

hypovolemia/carbohydrate

Post Spinal Anesthesia Hypotension and Preoperative Hydration

PEG3350 in ACLF With Hepatic Encephalopathy

Gastrointestinal Symptoms in Postural Orthostatic Tachycardia Syndrome

Fluid Responsiveness in the Postoperative Patient: a Prospective Study

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