Is there any difference between the renal resistive index between postoperative shock versus non shock patients?

Not yet recruiting

• Conditions: Pregnancy, childbirth and the puerperium, (2) ICD-10 Condition: P00-P96||Certain conditions originating in the perinatal period, (3) ICD-10 Condition: S00-T88||Injury, poisoning and certain other consequences of external causes, (4) ICD-10 Condition: M00-M99||Diseases of the musculoskeletal system and connective tissue,

• Registration Number: CTRI/2023/06/053906
• Lead Sponsor: Department of Anaesthesiology, Lady Hardinge Medical College and Associated Hospitals

Brief Summary

Study will be conducted after the approval from the institutional ethical committee and

registration with Clinical Trials Registry of India (CTRI). Patients fulfilling the inclusion

criteria will be recruited for the study. A written and informed voluntary consent will be

obtained from the patient or next to kin, after carefully explaining the procedure, its benefits

and risks in his/her vernacular. Any postoperative patient who will develop hypotension in ICU

will be treated as per standard protocol and if hypotension will not be corrected within first

three hour of resuscitation, then the first value of renal resistive index will be measured between

first 3 to 6 hours of development of shock. Renal resistive index of the patients will be measured

with SonositeTM Edge II Total portable ultrasound machine and P19 phased curvilinear array

probe (2-5MHz) in supine position. The probe will be placed in posterior axillary line to get an

image of kidney. RRI will be measured from interlobar or arcuate arteries adjacent to medullary

pyramids. Three sequential reading from upper, median, lower lobe will be taken and its

average will give the final RRI. RRI is calculated by the formula:

RRI= (peak systolic velocity-end diastolic velocity)/peak systolic velocity

IVC measurement will be done in short axis view with phased array probe(1-5MHz) in supine

position in short axis view. The difference between IVC measurement during expiration (IVCE)

and IVC measurement during inspiration (IVCI) and IVC collapsibility index will be calculated

as IVCE-IVCI/IVCE to assess intravascular volume in relation to the central venous pressure.

Cardiac Index (CI), Pulse Pressure Index (PPI) will be seen from Edward VIGILEO monitor

and transducer, connected to FLOTRAC sensor. FLOTRAC sensor will be connected to the

radial artery catheter of the patients The sensor will be placed at the level of right atrium before

pressure equilibration(zeroing).

Following details will be noted from patients:

1. Age

2. Gender

3. APACHE II score

4. SOFA score

5. Inferior vena cava diameter and collapsibility with respiration.

6. Risk factors for AKI like sepsis, hypotension & diabetes.

7. Renal function assessed with pre admission creatinine, eGFR

8. Urinary indices like FENa, FEurea, albumin/creatinine ratio

9. Daily measurement of change in hemodynamic parameters like HR, MAP, PPI, CVP, CI,

vasopressors dose, serum lactate, serum urea, serum creatinine, urine output and RRI up to 3

days

Detailed Description

Not available

Study Timeline

• Last Update Posted: 2023-06-13
• Study Start: 2023-06-27

Recruitment & Eligibility

• Status: Not Yet Recruiting
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• In shock group: 1.
• More than 18year old 2.
• Either sex 3.
• Requiring Intensive care admission and diagnosed with shock.
• In Non-shock group: 1.
• Requiring Intensive care admission due to any reason other than shock postoperatively.

Exclusion Criteria

• 1.Patients with renal insufficiency (eGFR <90ml/min) by Modification of Diet in Renal Disease criteria.16 2.Patients with dialysis dependency 3.
• Patients with monokidney 4.
• Patients after renal transplant.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Mean difference of RRI between shock & non-shock patients	72 hours

Secondary Outcome Measures

Name	Time	Method
Sensitivity & specificity, Positive Predictive Value, Negative Predictive Value of RRI to	predict AKI in both the groups.

Trial Locations

Locations (1)

Lady Hardinge Medical College and Associated Hospitals; 🇮🇳 Central, DELHI, India

Lady Hardinge Medical College and Associated Hospitals

🇮🇳Central, DELHI, India

Maheswari S

Principal investigator

9999001256

mahilavu2098@gmail.com