Carotid Artery Corrected Flow Time and Inferior Vena Cava Collapsibility Index for Prediction of Hypotension After Induction of General Anesthesia in Geriatric Patients Undergoing Elective Surgery
Tanta University
189 participants
Mar 1, 2025
OBSERVATIONAL
Conditions
Summary
In this observational study, we will assess cFT by Carotid ultrasound and IVC collapsibility index for prediction of hypotension after induction of general anesthesia in geriatric patients undergoing elective surgery.
Eligibility
Inclusion Criteria3
- American Society of Anaesthesiologists Physical Status I to Ⅱ
- receiving general anesthesia for elective surgery
- fasted for at least 6 to 8 hours were recruited in this study
Exclusion Criteria8
- • patients who refused to participate in the study
- American Society of Anaesthesiologists Physical Status Ⅲ or Ⅳ
- Patients with a history of peripheral arterial diseases or atherosclerosis
- Patients with body mass index of greater than 30 kg/m2
- Patients with arrhythmia or cardiomyopathy
- Chronic obstructive pulmonary disease (COPD)
- baseline systolic arterial pressure (SAP) ≥ 180 mmHg or \< 90mmHg
- Any episode of desaturation or difficult intubation during general anasethia induction
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Interventions
* The cFT is defined as the time between the onset of systolic flow until closure of the aortic valve corrected for the HR and has been found to correlate with the intravascular volume. * carotid ultrasound imaging will be performed 10 minutes before induction of general anesthesia in the preoperative holding area. * Ultrasound measurements will be performed under a vascular setting with a 6.0 to 13.0MHz linear array transducer * The right common carotid artery cFT will be measured in supine position with their heads tilted 30° to the left * After that, a pulse wave Doppler will be chosen, and the sampling frame will be positioned at an angle of less than 60° in the region of the carotid artery with the best color flow to acquire the blood flow spectrum.
* The IVC will be examined while the patient has been spontaneously, quietly breathing and lying in the supine position for at least 5 min before assessment. * A two-dimensional image of the IVC as it entered the right atrium will be obtained through the paramedian long-axis view via a subcostal approach using a curvilinear phased array probe (2-5 MHz) * Then, using M-mode imaging produced at a medium sweep speed, changes in IVC diameter with breathing will be evaluated 2 to 3 cm distal to the right atrium. * During the same respiratory cycle, measurements will be made of the IVC's greatest expiratory diameter (dIVC expiration) and lowest inspiratory diameter (dIVC inspiration). The formula IVCCI = (dIVC expiration - dIVC inspiration) × 100/dIVC expiration will be used to determine IVCCI as a percentage. (12) * IVCCI will be assessed by the same trained anesthesiologist who was blinded to postin duction hemodynamic measurements.
Locations(1)
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NCT06814054