Point of Care Ultrasound and Fluids Co-loading for the Prevention of Spinal-induced Hypotension in Trauma-elderly Patients and Cardiac Diseases

Status: Recruiting
Location: See location...
Intervention Type: Diagnostic test
Study Type: Observational
SUMMARY

In elderly patients with cardiac diseases, changes in cardiovascular physiology diminish cardiovascular reserve and predispose to significant hemodynamic instability after spinal anesthesia; hence, such patients could be at risk of postoperative complications. Additionally, point of care ultrasound (POCUS) and transthoracic echocardiography (TTE) are used in clinical practice to evaluate cardiovascular hemodynamics. Inferior vena cava (IVC) and its collapsibility index (CI) have been used in clinical practice for the prediction of post-spinal hypotension. Specifically, the dIVCmax-to-IVCCI ratio \< 48 showed high diagnostic performance among other indices in the prediction of post spinal hypotension in elderly patients with cardiac diseases undergoing proximal fracture repair. According to the above findings, the investigators hypothesized that fluid co-loading immediately after spinal anesthesia can lower the incidence of spinal-induced hypotension in patients with dIVCmax-to-IVCCI ratio \< 48. For this reason, it is prospectively evaluated echocardiographic indices of the LV and the right ventricle (RV), as well as of the IVC prior to spinal anesthesia in elderly patients with proximal femur fractures who had low LV-EF.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 70
Maximum Age: 100
View:

• All the included patients have dIVCmax-to-IVCCI ratio \< 48,

• LV-EF between 35% and 50%

• Normal RV function indices \[tricuspid annular plane systolic excursion (TAPSE) index \> 16 and tricuspid annular systolic velocity (TASV) \> 10 cm/sec and fractional area change (FAC) \> 35%)\]

Locations
Other Locations
Greece
Theodosios Saranteas
RECRUITING
Athens
Contact Information
Primary
Theodosios Saranteas, MD, PhD
thsaranteas@gmail.com
00306973928195
Time Frame
Start Date: 2024-01-02
Estimated Completion Date: 2026-06-30
Participants
Target number of participants: 60
Related Therapeutic Areas
Sponsors
Leads: Attikon Hospital

This content was sourced from clinicaltrials.gov