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

NCT06814054 | Recruiting DMC

• 1 other identifier: Hypotension in geriatrics
• Study Type: observational
• Target: 189
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Geriatrics; Hypotension on Induction; General Anesthetic Drug Adverse Reaction; Elective Surgery

Outcome Measures

Primary Outcomes (1)

• the diagnostic efficacy of cFT by Carotid ultrasound and IVC collapsibility index in prediction of hypotension after induction of general anesthesia in geriatric patients

  the diagnostic efficacy of cFT by Carotid ultrasound and IVC collapsibility index in prediction of hypotension after induction of general anesthesia in geriatric patients undergoing elective surgery.

  immediate preoperative peroid before the induction of general anesthesia

Study Arms (1)

GA induced hypotension in geriatrics

Postinduction hypotension will be defined as either * A 30% drop in SBP or 20% drop in MAP from baseline, or an absolute SBP of less than 90 mm Hg and MAP of less than 65 mm Hg within three minutes of general anaesthesia induction, every minute until 15 min after endotracheal intubation and before the start of any surgical manipulations. * Since endotracheal intubation and direct laryngoscopy can generate sympathetic activation, which will change blood pressure, we decided to start haemodynamic monitoring three minutes post endotracheal intubation. * If the MAP was less than 65 mmHg, a 250 ml crystalloid bolus will be administered and repeated as necessary. * If hypotension persist after IV fluid bolus, ephedrine will be given by three milligrams. At the end of surgery.

Diagnostic Test: Carotid Artery Corrected Flow Time measurement; Diagnostic Test: Inferior vena cava collapsibility index

Interventions

Carotid Artery Corrected Flow Time measurement DIAGNOSTIC_TEST

* 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.

GA induced hypotension in geriatrics

Inferior vena cava collapsibility index DIAGNOSTIC_TEST

* 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.

GA induced hypotension in geriatrics

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

geriatric patients (65 years and above) (10) of either sex and ASA PS I to Ⅱ receiving general anesthesia for elective surgery, who fasted for at least 6 to 8 hours were recruited in this study

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Faculty of medicine, Tanta university

Tanta, El Gharbyia, 31111, Egypt

RECRUITING

Study Officials

• tarek Mostafa

  tanta university, faculty of medicine

  PRINCIPAL INVESTIGATOR

Central Study Contacts

tarek AH Mostafa

CONTACT

01003591332; dr.tarek311@yahoo.com

sameh Ahmed

CONTACT

samehabdelkhalik1982@gmail.com

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principle investigator

Study Record Dates

• First Submitted: February 3, 2025
• First Posted: February 7, 2025
• Study Start: March 1, 2025
• Primary Completion: April 1, 2026
• Study Completion: May 1, 2026
• Last Updated: July 1, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)