Effect of Cardiorespiratory Changes on Carotid Flow Time During Lung Resection Surgery

NCT07808749 | Recruiting

• 1 other identifier: Registro:24/2023
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Cardiorespiratory changes during lung resection surgery, even though generally well tolerated, may lead to hemodynamic compromise, reducing venous return to the heart and hence cardiac output. Carotid corrected flow time is widely regarded as non-invasive index of preload status, yet its dynamic relationship with cardiac output, especially in surgical population is not well-studied. Understanding how cardiorespiratory changes affect carotid flow time in anesthesized patients remains limited. This study investigates corrected carotid flow time response to anesthesia, lateral position, one-lung ventilation, open chest, capnothorax, lung recruitment and volume expansion, hypothesizing that cFT declines in association with CO reduction during lung resection. The secondary interest of the study is to test whether carotid flow time and its recruitment-induced change can adequately predict fluid response during one-lung ventilation. In addition, the baseline preoperative carotid flow time and its position-induced change are studied as potential predictors of hemodynamic tolerance to lung recruitment and fluid response, respectively. Finally, the purpose of this study is to see if cardiorespiratory changes and volume expansion affect cerebral blood volume during lung resection surgery.

Conditions

Hemodynamic Monitoring

Keywords

carotid, cerebral circulation; hemodynamic instability

Outcome Measures

Primary Outcomes (1)

• Change in corrected carotid artery flow (ccFT) in association with cardiorespiratory changes and volume expansion during lung resection surgery

  Doppler ultrasonography measurements are performed repeatedly at following timepoints: awake (seated), awake (supine), after intubation, after lateral decubitus position, after transition to one-lung ventilation, after pleura opening, after carbon dioxide insufflation, before lung recruitment, after first highest PEEP, after second highest PEEP, after optimal PEEP, before and after volume expansion. Statistical analysis: within-patient change (Friedman, Wilcoxon signed rank), correlation

  enrollment phase (up to 2 years)

Secondary Outcomes (5)

• Diagnostic accuracy of corrected carotid flow time (ccFT) and recruitment - induced change in carotid corrected flow time (delta ccFTRM) in discriminating fluid responders during one-lung ventilation

  enrollment phase (up to 2 years)

• Diagnostic accuracy of baseline preoperative carotid flow time (ccFT) in discriminating between poor and good tolerance to recruitment maneuver and preoperative position-induced change in ccFT in discriminating fluid responders and non-responders.

  enrollment phase (up to 2 years); statistical analysis (ROC); outcome measure - prognostic ability (AUC) of preoperative corrected carotid flow time (ccFT) and position - induced change in ccFT (delta ccFTRM) in predicting poor tolerance or CO increase

• Change in cerebral blood volume index (CBVIl, CBVIr) in association with cardiorespiratory changes and volume expansion during lung resection surgery

  enrollment phase (up to 2 years)

• Change in secondary hemodynamic and ventilatory variables in response to cardiorespiratory changes and volume expansion during lung resection surgery

  enrollment phase (up to 2 years)

• Comparative between-group analysis of primary and secondary variables in patients of different sex, ventilation protocol, operative side, recruitment tolerance and fluid response.

  enrollment phase (up to 2 years)

Study Arms (1)

Longitudinal study

Repeated measurements design

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Surgical population

You may qualify if:

• patients scheduled to undergo thoracosocpic lung resection surgery

You may not qualify if:

• carotid stenosis or abnormal anatomy of carotid artery that prevents visualization, emphysema, arrythmia

Sponsors & Collaborators

• University of Valencia: lead
• Hospital General Valencia: collaborator

Study Sites (1)

Hospital General Valencia

Valencia, Spain

RECRUITING

Central Study Contacts

Manuel Granell Gil Prof.

CONTACT

609232031; margry@uv.es

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine

Study Record Dates

• First Submitted: June 30, 2026
• First Posted: September 9, 2026
• Study Start: January 27, 2025
• Primary Completion (Estimated): December 17, 2026
• Study Completion (Estimated): March 15, 2027
• Last Updated: September 9, 2026

Record last verified: 2026-09

Locations

ES (1)