Internal Jugular Vein Ultrasound and Acute Kidney Injury After Abdominal Surgery

NCT07638306 | Not Yet Recruiting

• 1 other identifier: 7979
• Study Type: observational
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

This observational study aims to learn whether changes in the internal jugular vein during anesthesia induction can help predict low blood pressure and kidney injury after surgery. The main questions it aims to answer are:

1. 1.Can the internal jugular vein collapsibility index before anesthesia predict low blood pressure during induction?
2. 2.Can the change in internal jugular vein collapsibility from before to just after anesthesia predict low blood pressure during surgery and acute kidney injury after surgery?

Conditions

Intraoperative Hypotension; Jugular Veins; Hypotension on Induction; General Anesthesia With Propofol

Keywords

Post-induction Hypotension; Internal Jugular Vein; Collapsibility Index; Propofol Induction; Acute Kidney Injury

Outcome Measures

Primary Outcomes (2)

• Post-induction hypotension

  Incidence of mean arterial pressure below 65 mmHg for atleast one consecutive minute during propofol induction

  Periprocedural

• Change in Internal Jugular Vein Collapsibility Index

  Difference between pre-induction and immediate post-induction internal jugular vein collapsibility index measured by point-of-care ultrasound

  From pre-induction to immediate post-induction

Secondary Outcomes (2)

• Postoperative Acute Kidney Injury

  Postoperative days one to three

• Cumulative Intra-operative Hypotension Burden

  Induction to End of Surgery

Other Outcomes (1)

• Cummulative Intra-operative Hypotension burden

  Induction to End of surgery

Study Arms (1)

Propofol Peri-induction IJV cohort

Prospective observational cohort of adult patients undergoing elective or urgent non-emergent major abdominal or visceral surgery under general anesthesia with propofol induction. Participants will undergo pre-induction and immediate post-induction internal jugular vein ultrasound measurements to evaluate whether changes in internal jugular vein collapsibility predict post-induction hypotension and postoperative acute kidney injury.

Procedure: Internal Jugular Vein Ultrasound Assesment

Interventions

Internal Jugular Vein Ultrasound Assesment PROCEDURE

Point-of-care Internal jugular vein ultrasound performed before induction and immediately after propofol induction to measure vein diameter and collapsibility index.

Propofol Peri-induction IJV cohort

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population consists of adults aged 18 years and older undergoing major abdominal or visceral surgery under general anesthesia with propofol induction at the Department of Anestesiology and Intensive Care Department in the Emergency County Hospital in Târgu Mureș. Patients will be enrolled prospectively in the preoperative period if they meet eligibility criteria, have routine perioperative blood pressure monitoring, and are able to undergo internal jugular vein ultrasound before and immediately after induction. The cohort will be followed through postoperative days 1 to 3 for creatinine-based assessment of acute kidney injury.

You may qualify if:

• Elective or Urgent (Non-emergent) major abdominal/ visceral surgery under general anesthesia
• General anesthesia with propofol induction (TCI/ manual)
• Expected surgical duration \> 60 minutes
• Continous BP monitoring (Invasive arterial line or non-invasive cuff at 2 minute recording intervals)
• Serum creatinine and eGFR (CKD-EPI) available within 30 days prior to surgery
• Written informed consent obtained before surgery
• Patient accessible by phone 30 days postoperatively

You may not qualify if:

• Emergency surgery (immediate life-saving, consent unobtainable)
• End-stage renal disease (eGFR \< 15 mL/min/1.73 m²) or dialysis-dependent
• Concomitant cardiac surgery or carotid endarterectomy
• Liver transplantation
• Known Internal Jugular Vein/ Inferior Vena Cava thrombosis or Superior Vena Cava syndrome
• Any anatomical neck abnormalities precluding Internal jugular vein ultrasound
• Induction with ketamine or etomidate as sole Induction agent
• Neuraxial anesthesia (spinal or epidural) before propofol induction
• Active decompensated heart failure (NYHA IV or acute pulmonary edema at time of Surgery)
• Same-admission reoperation within 30-day study window
• Withdrawal of consent at any point

Sponsors & Collaborators

• Tîrgu Mureș Emergency Clinical County Hospital, Romania: lead

Study Sites (1)

County Emergency Clinical Hospital of Targu Mureș

Târgu Mureş, Mureș County, 540136, Romania

Location

Related Publications (7)

• Saugel B, Sander M, Kouz K, Habicher M. Association of intraoperative hypotension and cumulative norepinephrine dose with postoperative acute kidney injury in patients having noncardiac surgery. Response to Br J Anaesth 2025; 134: 1552-3. Br J Anaesth. 2025 Jul;135(1):247-248. doi: 10.1016/j.bja.2025.03.035. Epub 2025 May 10. No abstract available.

  PMID: 40350350 BACKGROUND

• Salmasi V, Maheshwari K, Yang D, Mascha EJ, Singh A, Sessler DI, Kurz A. Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retrospective Cohort Analysis. Anesthesiology. 2017 Jan;126(1):47-65. doi: 10.1097/ALN.0000000000001432.

  PMID: 27792044 BACKGROUND

• Liu J, Lin SH, Zhao YS, Luo RJ, Zhang ZT, Wang LY, Xie K, Fan J, Zhang M, Chai YS, Tang H, Xu F. Incidence and risk factors of acute kidney injury after abdominal surgery: a systematic review and meta-analysis. Ann Med. 2025 Dec;57(1):2547324. doi: 10.1080/07853890.2025.2547324. Epub 2025 Aug 17.

  PMID: 40819346 BACKGROUND

• Okamura K, Nomura T, Mizuno Y, Miyashita T, Goto T. Pre-anesthetic ultrasonographic assessment of the internal jugular vein for prediction of hypotension during the induction of general anesthesia. J Anesth. 2019 Oct;33(5):612-619. doi: 10.1007/s00540-019-02675-9. Epub 2019 Aug 26.

  PMID: 31451896 BACKGROUND

• Yildirim SA, Dogan L, Sarikaya ZT, Ulugol H, Gucyetmez B, Toraman F. Hypotension after Anesthesia Induction: Target-Controlled Infusion Versus Manual Anesthesia Induction of Propofol. J Clin Med. 2023 Aug 14;12(16):5280. doi: 10.3390/jcm12165280.

  PMID: 37629322 BACKGROUND

• Sessler DI, Bloomstone JA, Aronson S, Berry C, Gan TJ, Kellum JA, Plumb J, Mythen MG, Grocott MPW, Edwards MR, Miller TE; Perioperative Quality Initiative-3 workgroup; POQI chairs; Miller TE, Mythen MG, Grocott MP, Edwards MR; Physiology group; Preoperative blood pressure group; Intraoperative blood pressure group; Postoperative blood pressure group. Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth. 2019 May;122(5):563-574. doi: 10.1016/j.bja.2019.01.013. Epub 2019 Feb 27.

  PMID: 30916004 BACKGROUND

• Sun Z, Wang K, Ji P. Incidence and risk factors for perioperative hypotension during noncardiac surgery: A retrospective cohort study. Medicine (Baltimore). 2026 Jan 9;105(2):e46451. doi: 10.1097/MD.0000000000046451.

  PMID: 41517769 BACKGROUND

MeSH Terms

Conditions

Acute Kidney Injury

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Month
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: May 21, 2026
• First Posted: June 10, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): January 31, 2027
• Study Completion (Estimated): March 28, 2027
• Last Updated: June 15, 2026

Record last verified: 2026-06

Locations

RO (1)