Effect of Internal Jugular Vein Catheterization on Intracranial Pressure Assessed by Optic Nerve Sheath Diameter and Carotid Doppler Ultrasonography: a Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 61
- 试验地点
- 1
- 主要终点
- Change in Optic Nerve Sheath Diameter (mm) Following Internal Jugular Vein Catheterization
研究概览
简要总结
This prospective observational study aims to evaluate the effect of internal jugular vein catheterization on intracranial pressure using optic nerve sheath diameter (ONSD) measurements and carotid artery Doppler ultrasonography in adult patients undergoing surgery under general anesthesia.
ONSD will be measured noninvasively using transorbital ultrasonography, and carotid Doppler parameters will be assessed at two time points: after endotracheal intubation and approximately 5 minutes after catheterization. The primary objective is to assess short-term changes in ONSD following catheterization.
Secondary objectives include evaluating changes in carotid Doppler measurements and their relationship with ONSD, as well as associations with physiological parameters such as blood pressure, heart rate, oxygen saturation, and end-tidal carbon dioxide.
详细描述
This prospective observational study is designed to investigate the effect of internal jugular vein catheterization on intracranial pressure using noninvasive ultrasonographic methods in adult patients undergoing elective surgery.
Internal jugular vein catheterization will be performed as part of routine clinical care in patients requiring central venous access. The study does not introduce any additional intervention beyond standard clinical practice.
Intracranial pressure will be indirectly assessed by measuring optic nerve sheath diameter (ONSD) using transorbital ultrasonography with a high-frequency linear probe. Measurements will be obtained at a standardized depth of 3 mm posterior to the optic disc.
In addition, carotid artery Doppler ultrasonography will be performed to assess hemodynamic parameters, including flow velocities and derived indices.
All ultrasonographic measurements will be performed at two predefined time points: after endotracheal intubation and approximately 5 minutes following internal jugular vein catheterization. Measurements will be obtained from the side of catheterization.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥18 years
- •Patients undergoing surgery under general anesthesia
- •Patients requiring internal jugular vein catheterization as part of routine clinical care
- •Ability to obtain optic nerve sheath diameter measurements using transorbital ultrasonography
- •Provision of informed consent
排除标准
- •Known intracranial pathology affecting intracranial pressure
- •Ocular conditions preventing accurate ultrasonographic measurement (e.g., orbital trauma, ocular surgery, infection)
- •Hemodynamic instability
- •Contraindication to internal jugular vein catheterization
- •Inability to obtain adequate ultrasound images
研究组 & 干预措施
Adult Patients Undergoing Internal Jugular Vein Catheterization
Adults undergoing elective surgery under general anesthesia who require internal jugular vein catheterization as part of routine clinical care. Intracranial pressure will be assessed noninvasively using optic nerve sheath diameter measurements obtained before and after catheterization.
干预措施: Internal Jugular Vein Catheterization (Procedure)
结局指标
主要结局
Change in Optic Nerve Sheath Diameter (mm) Following Internal Jugular Vein Catheterization
时间窗: Baseline (immediately after endotracheal intubation) and 5 minutes after internal jugular vein catheterization
Optic nerve sheath diameter (ONSD) will be measured in millimeters using transorbital ultrasonography at 3 mm posterior to the optic disc on the side of catheterization. The outcome is defined as the difference between measurements obtained immediately after endotracheal intubation (baseline) and 5 minutes after internal jugular vein catheterization. Higher values indicate increased optic nerve sheath diameter.
次要结局
- Change in Internal Carotid Artery Time-Averaged Maximum Velocity (TAMAX) Following Internal Jugular Vein Catheterization(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in Internal Carotid Artery Pulsatility Index (PI) Following Internal Jugular Vein Catheterization(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in Internal Carotid Artery Systolic/Diastolic Ratio (S/D) Following Internal Jugular Vein Catheterization(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in Mean Arterial Pressure (MAP)(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in Heart Rate(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in End-Tidal Carbon Dioxide (EtCO₂)(Baseline and 5 minutes after internal jugular vein catheterization)
- Change in Internal Carotid Artery Peak Systolic Velocity (PSV) Following Internal Jugular Vein Catheterization(Baseline (immediately after endotracheal intubation) and 5 minutes after internal jugular vein catheterization)
- Change in Internal Carotid Artery End-Diastolic Velocity (EDV) Following Internal Jugular Vein Catheterization(Baseline and 5 minutes after internal jugular vein catheterization)
研究者
Aysun Edehan
Principal Investigator
Kanuni Sultan Suleyman Training and Research Hospital