B-lines Score as Indicator for the Systemic Volumetric Load During TURP
NCT ID: NCT06079177
Last Updated: 2024-01-17
Study Results
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Basic Information
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NOT_YET_RECRUITING
125 participants
OBSERVATIONAL
2024-03-01
2024-12-30
Brief Summary
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The transurethral resection of the prostate syndrome (TURP-S) is a potentially life-threatening complication of the TURP surgery and timely diagnosis of TURP-S is crucial for rapid detection and optimized treatment.
This observational study is designed to investigate the use of LUS using B-lines as a bed-side, simple, and non-invasive indicator for predication of the presence of systemic volume overload in patients undergoing endoscopic TURP.
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Detailed Description
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Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Male patients with age ≥ 60 years undergoing TURP surgery
All patients will receive spinal anesthesia Under complete aseptic technique at level of L 4-L5 or L3-L4 using 12.5-15 mg of 0.5 % hyperbaric bupivacaine and 25 ug fentanyl.
Lung ultrasound score:
A curvilinear (5-2 MHz) probe will be used. The sliding multiple B-lines will be evaluated in eight antero-lateral lung examination zones.
Inferior vena cava (IVC) measurement using ultrasound:
A curvilinear (5-2 MHz) probe with B-mode scan will be used. Caval-Aorta index will be calculated by taking the ratio of the two respective diameters measured.
Other vital parameter as ,heart rate (HR), Mean arterial pressure (MAP), oxygen saturation (SpO2), arterial blood gases (ABG), serum Na and K levels will be measured and recorded at same time as the following:
(T0) ,(T1) ,(T2),(T3) ,(T30, T60, T90) intraoperative ,(T PACU),(T critical)
Ultrasound
LUS using B-lines Caval-Aorta index using ultrasound
Interventions
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Ultrasound
LUS using B-lines Caval-Aorta index using ultrasound
Eligibility Criteria
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Inclusion Criteria
* American Society of Anesthesiologists Classification (ASA ) I, II, and III.
* Full conscious patients.
Exclusion Criteria
* Who known allergic or hypersensitivity to any drug used in the study (local anesthesia).
* Coagulopathy (history of bleeding disorders), or patients on anticoagulant drugs, with (platelets \<50,000 International Normalised Ratio( INR)\>1.5).
* Patients have renal dysfunction patients with creatinine ≥ 2.
* Patients have uncontrolled cardiac diseases (IHD, (congestive heart failure (CHF), pulmonary hypertension and valvular diseases).
* Abdominal ascites.
* Patients with local infection at the site of local anesthetic injection.
* Failed spinal anesthesia.
* Timing not exceed 90 min.
* Any patient with lung ultrasound examination at T 0 ≥ 3 B-lines will be excluded from the study.
60 Years
90 Years
MALE
No
Sponsors
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Kasr El Aini Hospital
OTHER
Responsible Party
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Dalia Saad Abd-El Kader
assistant professor
Locations
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Dalia Saad
Cairo, , Egypt
Countries
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Central Contacts
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Facility Contacts
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Dalia Saad
Role: primary
References
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Demirel I, Ozer AB, Bayar MK, Erhan OL. TURP syndrome and severe hyponatremia under general anaesthesia. BMJ Case Rep. 2012 Nov 19;2012:bcr-2012-006899. doi: 10.1136/bcr-2012-006899.
Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. Eur Urol. 2006 Nov;50(5):969-79; discussion 980. doi: 10.1016/j.eururo.2005.12.042. Epub 2006 Jan 30.
Nakahira J, Sawai T, Fujiwara A, Minami T. Transurethral resection syndrome in elderly patients: a retrospective observational study. BMC Anesthesiol. 2014 Apr 23;14:30. doi: 10.1186/1471-2253-14-30. eCollection 2014.
Zhao Z, Jiang L, Xi X, Jiang Q, Zhu B, Wang M, Xing J, Zhang D. Prognostic value of extravascular lung water assessed with lung ultrasound score by chest sonography in patients with acute respiratory distress syndrome. BMC Pulm Med. 2015 Aug 23;15:98. doi: 10.1186/s12890-015-0091-2.
El-Baradey GF, El-Shmaa NS. Does caval aorta index correlate with central venous pressure in intravascular volume assessment in patients undergoing endoscopic transuretheral resection of prostate? Saudi J Anaesth. 2016 Apr-Jun;10(2):174-8. doi: 10.4103/1658-354X.168062.
Anile A, Russo J, Castiglione G, Volpicelli G. A simplified lung ultrasound approach to detect increased extravascular lung water in critically ill patients. Crit Ultrasound J. 2017 Dec;9(1):13. doi: 10.1186/s13089-017-0068-x. Epub 2017 Jun 13.
Volpicelli G, Skurzak S, Boero E, Carpinteri G, Tengattini M, Stefanone V, Luberto L, Anile A, Cerutti E, Radeschi G, Frascisco MF. Lung ultrasound predicts well extravascular lung water but is of limited usefulness in the prediction of wedge pressure. Anesthesiology. 2014 Aug;121(2):320-7. doi: 10.1097/ALN.0000000000000300.
Salama ER, Elkashlan M. Pre-operative ultrasonographic evaluation of inferior vena cava collapsibility index and caval aorta index as new predictors for hypotension after induction of spinal anaesthesia: A prospective observational study. Eur J Anaesthesiol. 2019 Apr;36(4):297-302. doi: 10.1097/EJA.0000000000000956.
Other Identifiers
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MD-295/2022
Identifier Type: -
Identifier Source: org_study_id
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