Reliability of Subclavian Vein Versus Inferior Vena Cava Collapsibility Indices for Preload Assessment.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 64
- 试验地点
- 1
- 主要终点
- inferior vena cava collapsibility index changes
研究概览
简要总结
Traditional methods for intravascular volume status assessment include physical examination, raised leg test, central venous pressure (CVP) and pulmonary artery catheters occlusion pressure (PAWP). Central venous pressure and pulmonary artery occlusion pressure are invasive and associated with significant complications. More recently, a number of less invasive techniques have been introduced, but they lack standardization and reliability. Ultrasonically, inferior vena cava collapsibility can detect hypovolemia non-invasively.
详细描述
The aim of this study is that measurement of subclavian vein collapsibility index(SCV-CI) could be potential adjunct to IVC-CI where the IVC visualization is impaired or not possible .
-Finding a non-invasive reliable accurate method for evaluation of intravascular volume and response to volume resuscitation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1. American society of anaesthesiologists physical status grade I and grade II .
- •2. Elective laparotomy.
- •Supine position
排除标准
- •Patient refusal .
- •Portal hypertension .
- •Severe peripheral vascular diseases.
- •Obstructive lung diseases .
- •Right sided heart failure , arrhythmia and valvular heart heart diseases .
- •Body mass index >35 kg/m2
研究组 & 干预措施
Inferior Vena Cava Collapsibility
inferior vena cava diameters is obtained in the supine position with a convex probe .The probe is placed in the subxiphoid region or the right anterior midaxillary plane.The sagittal section of IVC is imaged. M-mode probe is used to identify the measurement of minimum and maximum venous dimensions over the respiratory cycle using the 3.5-5 MHz phased array probe. To standardize the measurements, measuring of the IVC diameter is performed at 2 cm caudal of the junction point of the right atrium and IVC. The difference between the maximum (D max) and minimum (D min)diameters of the target vein is normalized according to the standard formula to yield the collapsibility index (CI).
干预措施: inferior vena cava collapsibility (Diagnostic Test)
Subclavian Vein Collapsibility
Right SCV diameters is checked in the supine position using a high frequency linear array probe (6-13 MHz) and M-mode. To standardize the measurements, the probe is placed beneath the proximal part of the middle part of the clavicle perpendicular to long-axis of the SCV to obtain the best cross-sectional view of the vien. After the target vein is localized , the dynamic diameter change is recorded using M-mode to identify and measure the minimum and maximum venous diameters.To calculate SCV collapsibility index, the standard formula is used.
干预措施: subclavian vein collapsibility (Diagnostic Test)
central venous pressure
ultrasound guided 7.5-F central venous catheter is introduced via right internal jugular vein under local analgesia with 2% lidocaine for measuring the CVP.
干预措施: central venous pressure (Diagnostic Test)
结局指标
主要结局
inferior vena cava collapsibility index changes
时间窗: intraoperative changes:1st basal before induction of anesthesia, 2nd before start of surgery, 3rd after10 ml/kg ringers preload, 4th 5 minutes before extubation.
ultrasound M mode maximum minus minimum over maximum then multiply by 100
次要结局
- subclavian vein collapsibility index changes(intraoperative changes:1st basal before induction of anesthesia, 2nd before start of surgery, 3rd after 10 ml/kg ringers preload, 4th 5 minutes before extubation.)
- fluid administration(Intraoperative)
- blood loss(intraoperative)
- central venous pressure changes(intraoperative changes:1st basal before induction of anesthesia, 2nd before start of surgery, 3rd after 10 ml/kg ringers preload, 4th 5 minutes before extubation.)
- heart rate changes(intraoperative changes:1st basal before induction of anesthesia, 2nd before start of surgery, 3rd after 10 ml/kg ringers preload, 4th 5 minutes before extubation.)
- mean blood pressure changes(intraoperative changes:1st basal before induction of anesthesia, 2nd before start of surgery, 3rd after 10 ml/kg ringers preload, 4th 5 minutes before extubation.)
- urine output(intraoperative)
研究者
Alaa Mazy Mazy
Associate professor of anesthesia and surgical intensive care
Mansoura University