Focussed Echocardiography to Detect Preoperative Hypovolemia and Left Ventricular Dysfunction as a Predictor of Post-Induction Hypotension

Post Graduate Institute of Medical Education and Research, Chandigarh

Status: Unknown

Conditions: Hypotension

Treatments: Other: Pre operative Focus assessed Transthoracic echocardiographic assessment.

Study type: Observational

Funder types: Other

Identifiers

NCT02944266

NK/2172/MD/11249-50

Details and patient eligibility

About

This is an observational study to evaluate the role of a Bed side Focus assessed Transthoracic Echocardiography (FATE) in identifying the patients at a potential risk of developing hypotension secondary to general anesthesia induction using the FATE parameters like velocity time integral ( VTI ), Inferior venacava diameter , Caval index and Left ventricular end end diastolic area.

Full description

Various haemodynamic parameters like central venous pressure , pulmonary capillary wedge pressure , systolic pulse pressure variations , stroke volume variation , pleth variability index etc are being used as markers of volume status and which in turn have been used as indicators of post general anesthesia induction hypotension in the past . In the current study the investigators aim to validate the role of a bed side 2-D transthoracic echocardiography (TTE) as a guide to identify the volume status of the patient before induction and clinically observe for the haemodynamic changes in the form of mean arterial pressure variations in the immediate post induction period.

The investigators aim to perform preoperative bed side Transthoracic echocardiography in 150 American society of Anesthesiologists grade-I/II patients posted for routine General anaesthesia procedures and assess their volume status . Then the investigators would collect 10 mean arterial pressure recordings at one minute interval in the immediate postinduction period and assess the accuracy of TTE in identifying potential patients at risk of developing post induction hypotension.

Enrollment: 150 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Any ASA - I/II patient posted for a routine general anaesthesia procedure and who do not fit with the exclusion criteria.

Exclusion criteria

• a) Extremes of age <18 years and >60 years

  b) BMI<18 and >40

  c) Patients with pre-existing hemodynamic instability, ventricular dysfunction and

Sepsis.

d) Patients on beta blocking agents.

e) Preinduction mean arterial pressure of <70 mm hg.

Trial design

150 participants in 2 patient groups

Hypovolemia group

Description:

Those patients who are said to be positive for one or more of the following TTE criteria are grouped under this , them being i.IVC diameter of less than 1 cm , ii.Caval index of \> 50%, iii.Left ventricular end diastolic area of \< 10 cm2 iv. VTI variation with respiration of \< 12.5%, are grouped under the hypovolaemia group .

Treatment:

Other: Pre operative Focus assessed Transthoracic echocardiographic assessment.

Normovolaemia group

Description:

Those patients without the above said TTE findings are hypothesised to be normovolaemic and grouped in here.

Treatment:

Other: Pre operative Focus assessed Transthoracic echocardiographic assessment.