Accuracy of Pre-Induction changes in Subclavian Vein Diameter and Collapsibility Index due to passive leg raising to predict the occurrence of Post-Induction hypotension in patients undergoing General Anaesthesia: A Cross-Sectional Study.
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- To find the accuracy of Pre-induction changes in subclavian vein diameter and collapsibility index due to passive leg raising in predicting post-induction hypotension in patients undergoing General Anaesthesia.
研究概览
简要总结
Hypotension is a common side effect of general anaesthesia and might lead to inadequate organ perfusion. It may also play a role in the development of postoperative ischemic stroke.
Increasing degree of hypotension is strongly associated with myocardial injury, mortality, and renal injury in postoperative critical care patients.
Intraoperative Hypotension (IOH) during noncardiac surgery is common and associated with increased 30-day major adverse cardiac or cerebrovascular events.
IOH should be defined using the absolute values stated in the Perioperative Quality Initiative (POQI) statement i.e., MAP < 60–70 mmHg or MAP < 20% of baseline.
Passive Leg Raising(PLR) has been shown to transfer up to 300 ml of blood from the peripheral compartment to the Central Compartment.
A majority of the incidence of IOH occurs before incision. IOH if predicted preoperatively can be better managed and post operative complications can be
prevented.
There are various methods which can be a reliable predictor of intraoperative hypotension which include: The Hypotension Prediction Index(HPI), Inferior Vena Cava Collapsibility Index (IVC CI) and Internal Jugular Vein (IJV). The HPI does not take into account the administration of different anaesthetic drugs. The association
of maximum pupil size to hypotension is confounded by the age of the patient. It is difficult to measure the IVC in obesity, bowel gas, or complex abdominal wounds.IJV has low diagnostic Accuracy.
Prediction of IOH using ultrasound guided parameters which are non invasive can help reduce postoperative morbidity due to hypotension.
It takes less time for measuring subclavian vein diameter changes compared to inferior vena cava. Also, To the best of our knowledge, very few studies have been conducted to predict IOH using Subclavian Vein Diameter Changes.
Therefore we have planned this study with the aim to know whether there is a Correlation of Pre op changes in Subclavian Vein Diameter and Collapsibility Index due to passive leg raising with Post induction hypotension.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 60.00 Year(s)（—）
- 性别
- All
入选标准
- •Patients Undergoing General Anaesthesia.
- •Patients satisfying American Society of Anaesthesiologists Class I, II and III.
排除标准
- •Patients undergoing emergency Surgery.
- •Patients with Peripheral Vascular Disease.
- •Patients with Cardiovascular Disease.
- •Patients with Pulmonary Disease.
- •Patients with Liver or Kidney Complications.
- •Patients unwilling to participate in study.
- •Patients with unclear ultrasound images.
结局指标
主要结局
To find the accuracy of Pre-induction changes in subclavian vein diameter and collapsibility index due to passive leg raising in predicting post-induction hypotension in patients undergoing General Anaesthesia.
时间窗: Sensitivity | Specificity | Positive Predictive Value | Negative Predictive Value | Receiver operative Characteristic (ROC) Curve
次要结局
- To find the accuracy of Pre-induction changes in subclavian vein diameter and collapsibility index due to passive leg raising in predicting post-induction hypotension in patients undergoing General Anaesthesia.(Sensitivity)
研究者
Dr Shadab Badar
N.K.P Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital