B-lines Score as Indicator for the Systemic Volumetric Load During TURP

B-lines Score Derived From Lung Ultrasonography as a Noninvasive Indicator for the Systemic Volumetric Load During TURP. A Prospective Observational Study.

Lung Ultrasonography score (LUS) using B-lines is a noninvasive, reliable and promising method for determining the extravascular lung water (EVLW). This was previously evaluated by trans-pulmonary thermodilution technique.

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.

Inclusion Criteria:

• Age ≥ 60 years.
• American Society of Anesthesiologists Classification (ASA ) I, II, and III.
• Full conscious patients.

Exclusion Criteria:

• Patient refusal.
• 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.