Caval Aorta Index, Collapsibility Index, Craniotomy, General Anesthesia, Induction, Inferior Vena Cava
Conditions
Brief summary
This study aims to assess the accuracy, repeatability, and reproducibility of preoperative evaluation of Inferior Vena Cava (IVC) collapsibility index and caval aorta index for prediction of hypotension after induction of general anesthesia.
Detailed description
Post- anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. The magnitude of hypotension is determined by the preoperative volume status, which varies depending on American Society of Anesthesiologists (ASA) physical status, preoperative comorbidities, preoperative medications, and fasting. General anesthesia causes significant alterations in hemodynamics, as both inhalational and intravenous anesthetics cause bradycardia, decrease in systemic vascular resistance and vasodilatation, and decrease in myocardial contractility, cardiac output and stroke volume, with the absence of surgical stimulus, making induction of anesthesia is the most crucial period at which hypotension occurs. Due to different definitions of hypotension and diverse patient populations, the effect of volume preload on prevention of hypotension is still controversial. Many recommendations to identified sonographic determination of inferior vena cava (IVC) collapsibility index (IVCCI) as non-invasive, and easy technique for evaluating volume status. Recent guidelines from the American Society of Echocardiography support the general use of IVCCI in assessing volume status.
Interventions
Inferior vena cava (IVC) collapsibility index (IVCCI) will be measured. The IVCCI is calculated using the following formula: IVCCI = (maximum IVC diameter - minimum IVC diameter) / maximum IVC diameter \* 100
OTHERCaval Aorta Index
The Inferior vena cava (IVC): Ao index will be derived by taking the ratio of the maximum IVC diameter during expiration and the maximal abdominal aortic diameter during systole. \- The caval aorta index (IVC/Ao) is calculated using the following formula: IVC/Ao index = IVC diameter / aortic diameter.
Sponsors
Ain Shams University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Age from 18 to 40 years. * Both sexes. * Body Mass Index\< 40 kg/m². * American Society of Anesthesiologists (ASA) physical status I, II. * Fasted according to the ASA guidelines: 2 hours for clear fluids, 6 hours after light meal, 8 hours after a full meal with high calorie or fat content. * Scheduled for elective craniotomy surgeries before induction of general anesthesia.
Exclusion criteria
* Current or recent pregnancy (within 3 months). * Pre-existing cardiac disease or hypertension. * On medications affecting blood pressure \[Beta-blockers (BBs) and calcium channel blockers (CCBs)\] . * Refusing to undergo the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO) | 15 minutes post-induction of general anesthesia. | Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Specificity of ultrasound guided Aorto-Caval index (IVC-AO) | 15 minutes post-induction of general anesthesia. | Specificity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded. |
| Sensitivity of inferior vena cava (IVC) collapsibility index | 15 minutes post-induction of general anesthesia. | Sensitivity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded. |
| Specificity of inferior vena cava (IVC) collapsibility index | 15 minutes post-induction of general anesthesia. | Specificity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded. |
Countries
Egypt
Contacts
CONTACTVerina F Zaref, MSc
Outcome results
None listed