SVC and Its Relationship to CVP Measurements in Liver Transplantation

Active, not recruiting

• Conditions: Liver Failure

• Registration Number: NCT02818218
• Lead Sponsor: The Cleveland Clinic

Brief Summary

Consecutive patients undergoing liver transplant surgery will be included in the study. Before surgical incision, during the preanhepatic phase, during the anhepatic phase, during the postanhepatic phase and following closure of the deep fascial layer of the anterior abdominal wall simultaneous measurement of SVC diameter, SBC collapsibility index and CVP will be recorded.

Detailed Description

Central venous pressure (CVP) measured invasively through a central venous catheter in the internal jugular vein or through a right atrial port of a pulmonary artery catheter is commonly used during liver transplant surgery. CVP measurements at the SVC-RA junction are a function of circulating blood volume, right ventricle function, intrathoracic pressure. CVP measurements can also be affected by the presence of tricuspid regurgitation. Because central venous pressure measurements are determined by several factors and do not predict the response to subsequent fluid bolus administration, they are considered "static measures" and are poor indicators of fluid responsiveness.

Given the entirely intrathoracic location of the superior vena cava (SVC), its diameter and collapsibility with positive pressure ventilation it is a potentially attractive method of non-invasively estimating CVP.

SVC diameter and collapsibility index, dynamic measures of fluid responsiveness have been successfully utilized as echocardiographic indices for fluid responsiveness in ventilated septic patients. Whether SVC collapsibility is correlated with CVP measurements in liver transplant patients is not known.

Consecutive patients undergoing liver transplant surgery will be included in the study. Before surgical incision, during the preanhepatic phase, during the anhepatic phase, during the postanhepatic phase and following closure of the deep fascial layer of the anterior abdominal wall simultaneous measurement of SVC diameter, SBC collapsibility index and CVP will be recorded.

Study Timeline

• Study First Submitted: 2016-04-11
• Study First Submitted QC: 2016-06-27
• Study First Posted: 2016-06-29
• Study Start: 2016-07-01
• Status Verified: 2024-05
• Primary Completion: 2024-05
• Last Update Submitted: 2024-05-06
• Last Update Posted: 2024-05-07
• Study Completion: 2024-06

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• 18 years of age
• undergoing liver transplantation surgery (cadaveric and living related)

Exclusion Criteria

• Contraindication to Transesophageal echocardiography

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Superior vena cava (SVC) diameter	during surgery	Superior vena cava (SVC) diameter

Secondary Outcome Measures

Name	Time	Method
Superior vena cava (SVC) collapsibility index	during surgery	It is a measure of the inspiratory decrease in SVC diameter will be determined
Change in Superior vena cava (SVC) diameter	during surgery	Change in Superior vena cava (SVC) diameter
Change in Superior vena cava (SVC) collapsibility index	during surgery	Change in Superior vena cava (SVC) collapsibility index
Correlation between SVC measurements and cardiac output/cardiac index	during surgery	Assess the correlation between SVC measurements and cardiac output/cardiac index

Trial Locations

Locations (1)

Cleveland Clinic Foundation; 🇺🇸 Cleveland, Ohio, United States