SVC and Its Relationship to CVP Measurements in Liver Transplantation

Liver Failure Clinical Trial

Official title:

SVC Diameter and Collapsibility Index and Its Relationship to Central Venous Pressure Measurements in Patients Undergoing Liver Transplantation

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT02818218
• Other study ID #: 16-307
• Status: Active, not recruiting
• Start date: July 1, 2016
• Est. completion date: June 2024

Study information

• Verified date: May 2024
• Source: The Cleveland Clinic
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Consecutive patients undergoing liver transplant surgery will be included in the study. Before surgical incision, during the preanhepatic phase, during the anhepatic phase, during the postanhepatic phase and following closure of the deep fascial layer of the anterior abdominal wall simultaneous measurement of SVC diameter, SBC collapsibility index and CVP will be recorded.

Description:

Central venous pressure (CVP) measured invasively through a central venous catheter in the internal jugular vein or through a right atrial port of a pulmonary artery catheter is commonly used during liver transplant surgery. CVP measurements at the SVC-RA junction are a function of circulating blood volume, right ventricle function, intrathoracic pressure. CVP measurements can also be affected by the presence of tricuspid regurgitation. Because central venous pressure measurements are determined by several factors and do not predict the response to subsequent fluid bolus administration, they are considered "static measures" and are poor indicators of fluid responsiveness.

Given the entirely intrathoracic location of the superior vena cava (SVC), its diameter and collapsibility with positive pressure ventilation it is a potentially attractive method of non-invasively estimating CVP.

SVC diameter and collapsibility index, dynamic measures of fluid responsiveness have been successfully utilized as echocardiographic indices for fluid responsiveness in ventilated septic patients. Whether SVC collapsibility is correlated with CVP measurements in liver transplant patients is not known.

Consecutive patients undergoing liver transplant surgery will be included in the study. Before surgical incision, during the preanhepatic phase, during the anhepatic phase, during the postanhepatic phase and following closure of the deep fascial layer of the anterior abdominal wall simultaneous measurement of SVC diameter, SBC collapsibility index and CVP will be recorded.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 100
• Est. completion date: June 2024
• Est. primary completion date: May 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• 18 years of age

• undergoing liver transplantation surgery (cadaveric and living related)

Exclusion Criteria:

• Contraindication to Transesophageal echocardiography

Related Conditions & MeSH terms

• Liver Failure

Intervention

Procedure:
• Liver Transplant
liver transplant recipient surgery

Locations

Country	Name	City	State
United States	Cleveland Clinic Foundation	Cleveland	Ohio

Sponsors (1)

Lead Sponsor	Collaborator
The Cleveland Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Superior vena cava (SVC) diameter	Superior vena cava (SVC) diameter	during surgery
Secondary	Change in Superior vena cava (SVC) diameter	Change in Superior vena cava (SVC) diameter	during surgery
Secondary	Change in Superior vena cava (SVC) collapsibility index	Change in Superior vena cava (SVC) collapsibility index	during surgery
Secondary	Superior vena cava (SVC) collapsibility index	It is a measure of the inspiratory decrease in SVC diameter will be determined	during surgery
Secondary	Correlation between SVC measurements and cardiac output/cardiac index	Assess the correlation between SVC measurements and cardiac output/cardiac index	during surgery