Ultrasound in Evaluation of Preoperative Fluid Management of Hip Fracture Surgery Patients

Study Overview
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Brief Summary
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Goal directed fluid therapy is a new standard surgical procedure which is successful in patients undergoing hip revision arthroplasty, There has been a reduction of postoperative complications, most importantly surgery with a decrease inbleeding, as well as in hospital and intensive care stays it is related. The aim of this study is to evaluate effectiveness of pulmonary ultrasound score and vena cava collapse index measurements in the patients undergoing hip surgery under spinal anesthesia and relation with peroperative fluid management.

Detailed Description
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Patients who will undergo hip surgery under spinal anesthesia using the closed envelope method it will be randomized and divided into 2 groups. 1.The inferior vena cava collapse index IVC CI and lung ultrasound score (LUS) measurements and goal directed fluid therapy will be done 2. Group applying zero balance liquid therapy to patients with conventional methods is planned. Patients in the group will be started with fluid replasment at an hourly rate of 2ml/kg/h and with ultrasound measurement the infused fluid will be evaluated and regulated. Crystalloid liquid infusion at a rate of 2ml/kg/hour will be administered to the patients in the group additional fluid replacement will be decided by monitoring bleeding and urinary output, zero balance is aimed at patients. Both groups were treated with spinal anesthesia in the postoperative period 120. minute IVC CI and the LUS score value will be checked. If the CI is below 50% and the LUS score is below 15, fluid management will be considered as successful.

Official Title
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Evaluation of Ultrasound on Peroperative Fluid Management in Patients Undergoing Hip Surgery Under Spinal Anesthesia

Conditions
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Lung Edema, Hip Fractures

Intervention / Treatment
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* Device: ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over the age of 65 who will undergo hip surgery ASA I-II-III patients Exclusion Criteria: Patients under the age of 65 Patients with ASA IV-V Patients with BMI>above 35 Patients with an Lus score of 15 and above Patients who have not undergone spinal anesthesia

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 110 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Goal directed<br>The inferior vena cava collapse index IVC CI and lung ultrasound score (LUS) measurements and goal directed fluid therapy will be done.Patients in the group will be started with fluid replasment at an hourly rate of 2ml/kg/h and with ultrasound measurement the infused fluid will be evaluated and regulated. | Device: ultrasound<br>* a device which is used in intensive care units,<br>|
| conventional<br>. Group applying zero balance liquid therapy to patients with conventional methods is planned. Crystalloid liquid infusion at a rate of 2ml/kg/hour will be administered to the patients in the group additional fluid replacement will be decided by monitoring bleeding and urinary output, zero balance is aimed at patients. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| comparison of groups for change of vena cava inferior collapsibility index in 4 time frames | vena cava inferior collapsibility index will be measured at 4 time frames by using ultrasound,changes over 20% will be considered as significant | vena cava inferior collapsibility index measurements will be done in 4 time frames.1.just before spinal anesthesia, 2. at fifth minute of surgery ,3. at 15. minute of surgery, 4 immediatelyafter surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| comparison of groups for pulmonary edema | detecting 12 parts of lung with ultrasound with a score of 1-36 | measurements will be done in 4 time frames.1.just before spinal anesthesia, 2. at fifth minute of surgery ,3. at 15. minute of surgery, 4immediately after surgery |