The Effect of İnferior Vena Cava Diameter and Collapsibility Index on Fluid Management

Hypovolemia Clinical Trial

Official title: The Effect of Ultrasonography-Assisted İnferior Vena Cava Diameter and Collapsibility Index on Fluid Management in Gynecological Cases Performing Pelvic Surgery

Status Active, not recruiting

Clinical Trial Summary

Before general anesthesia, patients are usually taken into surgery after 8-10 hours of fasting. During this fasting period, patients may experience fluid deficit. Nowadays, inferior vena cava (IVC) imaging with ultrasonography (USG) and inferior vena cava collapsibility index (IVCCI) calculation are widely used non-invasive, easy, fast and reliable methods for evaluating fluid deficit. In this study, whether IVC diameter and IVCCI displayed before general anesthesia can predict hypotension developing after general anesthesia, whether preoperative fluid infusion contributes to patient hemodynamics, also we aim are IVC diameter and IVCCI investigate the correlation between with used to predict other fluid deficits, pulse pressure change (PPV), perfusion index (PI), pleth variability index (PVI) and peripheral blood hemoglobin (SpHb).

Clinical Trial Description

The study was conducted as a prospective randomized controlled study. The study, age 18-75, American Society of Anesthesiologists scores (ASA) I-II- III who, will be under general anehestesia pelvic surgery performed 122 patients were included. 10 patients were excluded from the study due to insufficient image quality and 2 patients were excluded due to the initiation of vasoactive drug infusion. Two groups were formed from the patients evaluated, with 55 people in each group. They were classified as those who received intravenous fluid maintenance during the preoperative fasting period (group A) and those who were given a calculated amount of fluid intraoperatively (group B). The maximum IVC diameter (dIVCmax) and minimum IVC diameter (dIVCmin) of the patients were measured in the preoperative and postoperative periods. IVKKI was calculated [(dIVKmax- dIVKmin)/dIVKmax ×100%]. Those with serious cardiac disease (patients not in sinus rhythm, pulmonary hypertension, unstable angina or ejection fraction less than 40%), obese patients, body mass index (BMI) >35, patients whose IVC cannot be visualized, increased abdominal pressure, major peripheral artery disease, patients with a pacemaker, using angioreceptor blockers, patients with a hypotensive course (those with systolic arterial pressure <30 mmHg despite inotropic infusion over 1mcg/kg/min), patients with severe hypertension (systolic blood pressure >180 mmHg, diastole>110 mmHg). ), patients with open wounds in the USG area, patients with body temperature >37.5 °C, patients with partial carbon dioxide pressure (PaCO2) in arterial blood gas >60 mmHg, patients with mental retardation and limited cooperation, and patients who did not agree to participate in the study were not included in the study. Peripheral oxygen saturation (SpO2), PPV PI, PVI, SpHb, electrocardiography (ECG) and invasive blood pressure monitoring were performed on the patients. Blood pressure was measured by invasive (radial artery) method. Hypotension was considered as systolic blood pressure below 90 mmHg, mean arterial pressure (MAP) decreasing by more than 30% compared to the baseline value or below 60 mmHg, or a combination of the two. ;

Related Conditions & MeSH terms

• Hypovolemia

• NCT number: NCT06231472
• Study type: Interventional
• Source: Istanbul Medeniyet University
• Status: Active, not recruiting
• Phase: N/A
• Start date: May 1, 2022
• Completion date: March 1, 2024