Internal Jugular Venous Distensibility Index and Innominate Venous Flow Patterns as Predictors of Fluid Responsiveness

Study Overview
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Brief Summary
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The measurement of internal jugular vein distensibility index corresponds to the measurement of stroke volume using trans-thoracic Doppler echocardiography in assessing the response to fluid administration in elective surgical patients.

Official Title
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Internal Jugular Venous Distensibility Index and Innominate Venous Flow Patterns as Predictors of Response to Fluid Administration in Elective Surgery Patients

Conditions
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Fluid Responsiveness, Hemodynamic Monitoring

Intervention / Treatment
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* Device: Ultrasonography of Internal Jugular Vein
* Device: Doppler Echocardiograhy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Utilizing intraoperative mechanical ventilation with a tidal volume of 8 ml/kg (PBW). ASA physical status 1-3. Mongoloid ethnicity. Willing to participate in the research and sign the informed consent. Exclusion Criteria: Patients with symptoms and signs of fluid overload, such as pulmonary edema, pleural effusion, ascites, and peripheral edema. Patients with chronic or acute kidney dysfunction, renal replacement therapy history, and/or oliguria (urine output <0.5 ml/kg/hour). Patients with cardiovascular diseases, including heart failure, cardiac arrhythmias, moderate-to-severe valvular abnormalities, a history of angina/myocardial infarction, pulmonary hypertension, and peripheral artery disease. Patients with anatomical abnormalities in the neck and chest region that make it impractical to perform jugular vein ultrasound and transthoracic echocardiography. Jugular vein thrombosis. Superior vena cava syndrome. Placement of jugular vein catheter. Body mass index (BMI) greater than 30.0 kg/m2. Patients with contraindications to the use of muscle relaxants. Patients with lung hyperinflation and pleural effusion. Drop out criteria: Patients who wish to withdraw from the study. Post-anesthesia induction complications and emergencies. Transthoracic echocardiography provides a less representative image due to difficult acoustic window.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Ultrasonography of Internal Jugular Vein|Non invasive monitoring of fluid responsiveness|
|Device: Doppler Echocardiograhy|Non invasive monitoring of fluid responsiveness|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| IJV distensibility index correlation to fluid responsiveness | Correlation between IJV distensibility index and fluid responsiveness defined as increase of stroke volume more than 10% after fluid challenge | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of IJV distensibility index in fluid responders and non-fluid responders. |  | 1 day | 
| Detection of sensitivity, specificity, positive predictive value, negative predictive value, and best cut off value of IJV distensibility index to predict fluid responsiveness | By ROC curve and Youden index | 1 day | 
| Correlation of IJV distensibility index and stroke volume |  | 1 day | 
| Innominate vein flow velocity correlation to fluid responsiveness | Correlation between Innominate vein flow velocity and fluid responsiveness defined as increase of stroke volume more than 10% after fluid challenge | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Internal Jugular Venous Distensibility Index, Innominate Venous Flow Patterns