IJV Sonogram VS Cardiometry in Fluid Responsiveness In CABG

Study Overview
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Brief Summary
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The primary aim of the study is to assess the reliability of predicting fluid responsiveness in adults undergoing coronary artery bypass graft surgery using sonogram of the internal jugular vein for assessment of vessel distensibility in relation to stroke volume variation (SVV) measaured by electrical cardiometry. The secondary aim is to evaluate the ability of thoracic fluid content (TFC) measured by electrical cardiometry to be an additive value for the assessment of fluid responsiveness.

Detailed Description
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Fluid management is one of the most important treatments for stabilizing hemodynamics in patients after cardiac surgery.Electrical Cardiometry is a method for the non-invasive determination of stroke volume (SV), cardiac output (CO), stroke volume variation (SVV) and other hemodynamic parameters in adults, children, and neonates based on measurement of thoracic electrical bioimpedance and has been validated against gold standard methods such as thermodilution method of deriving CO using a pulmonary artery catheter (PAC). The IJV is, technically, much more easily accessible for sonographic visualization than the IVC, and measurement of the IJV does not require transesophageal echocardiography (TEE). Internal jugular vein distensibility index (IJVDI) has been studied in several studies but its reliability has not been well confirmed in patients during cardiac surgery. This is a prospective observational study of adults undergoing coronary artery bypass graft surgery . The primary aim of the study is to assess the reliability of predicting fluid responsiveness in adults undergoing coronary artery bypass graft surgery using sonogram of the internal jugular vein for assessment of vessel distensibility in relation to stroke volume variation (SVV) measaured by electrical cardiometry.The secondary aim is to evaluate the ability of thoracic fluid content (TFC) measured by electrical cardiometry to be an additive value for the assessment of fluid responsiveness. Volume responsiveness will be independently assessed by IJV sonogram and electrical cardiometry in following times After induction of anesthesia. After transfusing 6 ml / kg of hydroxyethyl starch (HES) 6% before sternotomy. After closure of the sternum and transfusion of patient's blood. Immediately before transferring the patient to ICU and stabilization of hemodynamic parameters by giving fluids needed to patient. Immediately after transferring the patient to ICU and stabilization of hemodynamic parameters by giving fluids needed to patient. After 2 hour of ICU admission. Before weaning from mechanical ventilation Fluid responsiveness will be assessed by examining SVV with a threshold of the SVV = 12% allow discrimination between Responders and Non-responders

Official Title
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Internal Jugular Vein Sonogram Versus Electrical Cardiometry For Assessment Of Fluid Responsiveness In Adult Undergoing Coronary Artery Bypass Graft Surgery

Conditions
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Ultrasound of IJV, Electrical Cardiometry

Intervention / Treatment
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* Diagnostic Test: internal jugular vein distensibility index


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults (>18 years old) Able to provide advanced informed consent Planned for elective CABG surgery Exclusion Criteria: Age < 18 years Severely reduced preoperative left ventricular ejection fraction < 40 % Significant cardiac arrhythmia. Significant valvular heart disease. Clinically evident pulmonary disease. Bilaterally inserted venous catheters (jugular or subclavian vein) History of radiotherapy or surgery of the neck region. Inability to obtain interpretable ultrasound images due to a difficult acoustic window.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: internal jugular vein distensibility index|It is a prospective observational clinical study to correlate hemodynamic monitoring between Electrical Cardiometry and internal jugular vein distensibility index by sonogram|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fluid responsiveness after fluid challenge | Correlation between SVV and IJVDI | 24 hours from the start of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CABG surgery, Internal jugular vein, stroke volume variation, TFC