B-lines Score as Indicator for the Systemic Volumetric Load During TURP

Kasr El Aini Hospital

Status: Not yet enrolling

Conditions: Transurethral Resection of Prostate

Treatments: Device: Ultrasound

Study type: Observational

Funder types: Other

Identifiers

NCT06079177

MD-295/2022

Details and patient eligibility

About

Lung Ultrasonography score (LUS) using B-lines is a noninvasive, reliable and promising method for determining the extravascular lung water (EVLW). This was previously evaluated by trans-pulmonary thermodilution technique.

The transurethral resection of the prostate syndrome (TURP-S) is a potentially life-threatening complication of the TURP surgery and timely diagnosis of TURP-S is crucial for rapid detection and optimized treatment.

This observational study is designed to investigate the use of LUS using B-lines as a bed-side, simple, and non-invasive indicator for predication of the presence of systemic volume overload in patients undergoing endoscopic TURP.

Enrollment: 125 estimated patients

Sex: Male

Ages: 60 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 60 years.
• American Society of Anesthesiologists Classification (ASA ) I, II, and III.
• Full conscious patients.

Exclusion criteria

• Patient refusal.
• Who known allergic or hypersensitivity to any drug used in the study (local anesthesia).
• Coagulopathy (history of bleeding disorders), or patients on anticoagulant drugs, with (platelets <50,000 International Normalised Ratio( INR)>1.5).
• Patients have renal dysfunction patients with creatinine ≥ 2.
• Patients have uncontrolled cardiac diseases (IHD, (congestive heart failure (CHF), pulmonary hypertension and valvular diseases).
• Abdominal ascites.
• Patients with local infection at the site of local anesthetic injection.
• Failed spinal anesthesia.
• Timing not exceed 90 min.
• Any patient with lung ultrasound examination at T 0 ≥ 3 B-lines will be excluded from the study.

Trial design

125 participants in 1 patient group

Male patients with age ≥ 60 years undergoing TURP surgery

Description:

All patients will receive spinal anesthesia Under complete aseptic technique at level of L 4-L5 or L3-L4 using 12.5-15 mg of 0.5 % hyperbaric bupivacaine and 25 ug fentanyl. Lung ultrasound score: A curvilinear (5-2 MHz) probe will be used. The sliding multiple B-lines will be evaluated in eight antero-lateral lung examination zones. Inferior vena cava (IVC) measurement using ultrasound: A curvilinear (5-2 MHz) probe with B-mode scan will be used. Caval-Aorta index will be calculated by taking the ratio of the two respective diameters measured. Other vital parameter as ,heart rate (HR), Mean arterial pressure (MAP), oxygen saturation (SpO2), arterial blood gases (ABG), serum Na and K levels will be measured and recorded at same time as the following: (T0) ,(T1) ,(T2),(T3) ,(T30, T60, T90) intraoperative ,(T PACU),(T critical)

Treatment:

Device: Ultrasound