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

Mustafa Burgac

Status

Active, not recruiting

Conditions

Hypovolemia

Treatments

Procedure: peroperative inferior vena cava measurement

Study type

Interventional

Funder types

Other

Identifiers

NCT06231472

2022/0263

Details and patient eligibility

About

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).

Full 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.

Enrollment

110 estimated patients

Sex

Female

Ages

18 to 75 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Gynaecological pelvic surgery patients aged 18-75 years
Patients with an American Society of Anaesthetists score of 1-2-3

Exclusion criteria

Those with serious cardiac disease
Obese harvests are those with BMI >35
Those with major peripheral vascular disease
Those with increased abdominal pressure
Patients with pacemakers
Patients using angioreceptor blockers
Patients whose inferior vena cava cannot be visualized
Patients with a hypotensive course (those whose persistence is <30 mmHg despite inotrope infusion over 1mcg/kg/min)
Patients with severe hypertension (systolic 180 mmhg, diastolic>110 mmhg)
Those with open wounds in the USG area
Those with body temperature >37.5
Those with pco2 > 60 mmhg in arterial blood gas
Patients with mental retardation and limited cooperation