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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Patients scheduled for elective craniotomy surgeries before induction of general anesthesia. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Inferior vena cava collapsibility index | Other | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO) | Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded. | 15 minutes post-induction of general anesthesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Specificity of ultrasound guided Aorto-Caval index (IVC-AO) | Specificity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded. | 15 minutes post-induction of general anesthesia. |
| Sensitivity of inferior vena cava (IVC) collapsibility index |
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Inclusion Criteria:
Exclusion Criteria:
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This prospective cohort study will be conducted on 40 patients undergoing craniotomy surgeries at Ain Shams University Hospitals.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Verina F Zaref, MSc | Contact | 00201098858385 | verina.fares@med.asu.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University Hospitals | Recruiting | Cairo | 11591 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Dec 1, 2023 | Nov 1, 2025 |
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| Caval Aorta Index | Other | 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. |
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Sensitivity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded. |
| 15 minutes post-induction of general anesthesia. |
| Specificity of inferior vena cava (IVC) collapsibility index | Specificity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded. | 15 minutes post-induction of general anesthesia. |
| Prot_000.pdf |