IJV Sonogram VS Cardiometry in Fluid Responsiveness In CABG

NCT ID: NCT04618419

Last Updated: 2020-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-05-10

Study Completion Date

2020-01-05

Brief Summary

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The primary aim of the study is to assess the reliability of predicting fluid responsiveness in adults undergoing coronary artery bypass graft surgery using sonogram of the internal jugular vein for assessment of vessel distensibility in relation to stroke volume variation (SVV) measaured by electrical cardiometry.

The secondary aim is to evaluate the ability of thoracic fluid content (TFC) measured by electrical cardiometry to be an additive value for the assessment of fluid responsiveness.

Detailed Description

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Fluid management is one of the most important treatments for stabilizing hemodynamics in patients after cardiac surgery.Electrical Cardiometry is a method for the non-invasive determination of stroke volume (SV), cardiac output (CO), stroke volume variation (SVV) and other hemodynamic parameters in adults, children, and neonates based on measurement of thoracic electrical bioimpedance and has been validated against "gold standard" methods such as thermodilution method of deriving CO using a pulmonary artery catheter (PAC).

The IJV is, technically, much more easily accessible for sonographic visualization than the IVC, and measurement of the IJV does not require transesophageal echocardiography (TEE). Internal jugular vein distensibility index (IJVDI) has been studied in several studies but its reliability has not been well confirmed in patients during cardiac surgery.

This is a prospective observational study of adults undergoing coronary artery bypass graft surgery . The primary aim of the study is to assess the reliability of predicting fluid responsiveness in adults undergoing coronary artery bypass graft surgery using sonogram of the internal jugular vein for assessment of vessel distensibility in relation to stroke volume variation (SVV) measaured by electrical cardiometry.The secondary aim is to evaluate the ability of thoracic fluid content (TFC) measured by electrical cardiometry to be an additive value for the assessment of fluid responsiveness.

Volume responsiveness will be independently assessed by IJV sonogram and electrical cardiometry in following times

1. After induction of anesthesia.
2. After transfusing 6 ml / kg of hydroxyethyl starch (HES) 6% before sternotomy.
3. After closure of the sternum and transfusion of patient's blood.
4. Immediately before transferring the patient to ICU and stabilization of hemodynamic parameters by giving fluids needed to patient.
5. Immediately after transferring the patient to ICU and stabilization of hemodynamic parameters by giving fluids needed to patient.
6. After 2 hour of ICU admission.
7. Before weaning from mechanical ventilation Fluid responsiveness will be assessed by examining SVV with a threshold of the SVV = 12% allow discrimination between Responders and Non-responders

Conditions

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Ultrasound of IJV Electrical Cardiometry

Keywords

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CABG surgery Internal jugular vein stroke volume variation TFC

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Interventions

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internal jugular vein distensibility index

It is a prospective observational clinical study to correlate hemodynamic monitoring between Electrical Cardiometry and internal jugular vein distensibility index by sonogram

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

Adults (\>18 years old) Able to provide advanced informed consent Planned for elective CABG surgery

Exclusion Criteria

* Age \< 18 years
* Severely reduced preoperative left ventricular ejection fraction \< 40 %
* Significant cardiac arrhythmia.
* Significant valvular heart disease.
* Clinically evident pulmonary disease.
* Bilaterally inserted venous catheters (jugular or subclavian vein)
* History of radiotherapy or surgery of the neck region.
* Inability to obtain interpretable ultrasound images due to a difficult acoustic window.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ahmed Abd El-Rahim Abd El-Hamid Hammad

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Abd El-Rahim Abd El-Hamid Hammad

Residentat department of anaesthesia and surgical intensive Care

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Alexandria university

Alexandria, , Egypt

Site Status

Countries

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Egypt

References

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Aronson S, Nisbet P, Bunke M. Fluid resuscitation practices in cardiac surgery patients in the USA: a survey of health care providers. Perioper Med (Lond). 2017 Oct 19;6:15. doi: 10.1186/s13741-017-0071-6. eCollection 2017.

Reference Type BACKGROUND
PMID: 29075482 (View on PubMed)

Ma GG, Hao GW, Yang XM, Zhu DM, Liu L, Liu H, Tu GW, Luo Z. Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients with mechanical ventilation. Ann Intensive Care. 2018 Jan 16;8(1):6. doi: 10.1186/s13613-017-0347-5.

Reference Type BACKGROUND
PMID: 29340792 (View on PubMed)

Other Identifiers

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IJVDI and fluid responsiveness

Identifier Type: -

Identifier Source: org_study_id