Preoperative Evaluation of IVC Collapsibility Index and Caval Aorta Index After Induction of General Anesthesia

Preoperative Evaluation of IVC Collapsibility Index and Caval Aorta Index for Prediction of Hypotension After Induction of General Anesthesia in Patients Undergoing Craniotomy Surgeries

This study aims to assess the accuracy, repeatability, and reproducibility of preoperative evaluation of Inferior Vena Cava (IVC) collapsibility index and caval aorta index for prediction of hypotension after induction of general anesthesia.

Study Overview

• Status: Recruiting
• Conditions: General Anesthesia; Craniotomy; Induction; Inferior Vena Cava; Collapsibility Index; Caval Aorta Index
• Intervention / Treatment: Other: Inferior vena cava collapsibility index; Other: Caval Aorta Index

Detailed Description

Post- anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. The magnitude of hypotension is determined by the preoperative volume status, which varies depending on American Society of Anesthesiologists (ASA) physical status, preoperative comorbidities, preoperative medications, and fasting.

General anesthesia causes significant alterations in hemodynamics, as both inhalational and intravenous anesthetics cause bradycardia, decrease in systemic vascular resistance and vasodilatation, and decrease in myocardial contractility, cardiac output and stroke volume, with the absence of surgical stimulus, making induction of anesthesia is the most crucial period at which hypotension occurs.

Due to different definitions of hypotension and diverse patient populations, the effect of volume preload on prevention of hypotension is still controversial. Many recommendations to identified sonographic determination of inferior vena cava (IVC) collapsibility index (IVCCI) as non-invasive, and easy technique for evaluating volume status. Recent guidelines from the American Society of Echocardiography support the general use of IVCCI in assessing volume status.

• Study Type: Observational
• Enrollment (Estimated): 36

Contacts and Locations

• Study Contact: Name: Verina F Zaref, MSc; Phone Number: 00201098858385; Email: verina.fares@med.asu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt, 11591
    • Recruiting
    • Ain Shams University Hospitals
    • Contact: Verina F Bekheet, MSc; Phone Number: 00201098858385; Email: verina.fares@med.asu.edu.eg
    • Sub-Investigator: Sherif W Sarguios, MD
    • Sub-Investigator: Dalia A Mohamed, MD
    • Sub-Investigator: Noha M EL-Tobgy, MD
    • Sub-Investigator: Mai M Elhefny, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

This prospective cohort study will be conducted on 40 patients undergoing craniotomy surgeries at Ain Shams University Hospitals.

Description

Inclusion Criteria:

• Age from 18 to 40 years.
• Both sexes.
• Body Mass Index< 40 kg/m².
• American Society of Anesthesiologists (ASA) physical status I, II.
• Fasted according to the ASA guidelines: 2 hours for clear fluids, 6 hours after light meal, 8 hours after a full meal with high calorie or fat content.
• Scheduled for elective craniotomy surgeries before induction of general anesthesia.

Exclusion Criteria:

• Current or recent pregnancy (within 3 months).
• Pre-existing cardiac disease or hypertension.
• On medications affecting blood pressure [Beta-blockers (BBs) and calcium channel blockers (CCBs)] .
• Refusing to undergo the study.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Study group; Patients scheduled for elective craniotomy surgeries before induction of general anesthesia.

Other: Inferior vena cava collapsibility index; Inferior vena cava (IVC) collapsibility index (IVCCI) will be measured. The IVCCI is calculated using the following formula: IVCCI = (maximum IVC diameter - minimum IVC diameter) / maximum IVC diameter * 100; Other: Caval Aorta Index; The Inferior vena cava (IVC): Ao index will be derived by taking the ratio of the maximum IVC diameter during expiration and the maximal abdominal aortic diameter during systole. - The caval aorta index (IVC/Ao) is calculated using the following formula: IVC/Ao index = IVC diameter / aortic diameter.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO)	Sensitivity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded.	15 minutes post-induction of general anesthesia.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Specificity of ultrasound guided Aorto-Caval index (IVC-AO)	Specificity of ultrasound guided Aorto-Caval index (IVC-AO) to predict hypotension will be recorded.	15 minutes post-induction of general anesthesia.
Sensitivity of inferior vena cava (IVC) collapsibility index	Sensitivity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded.	15 minutes post-induction of general anesthesia.
Specificity of inferior vena cava (IVC) collapsibility index	Specificity of inferior vena cava (IVC) collapsibility index to predict hypotension will be recorded.	15 minutes post-induction of general anesthesia.

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): January 14, 2024
• Primary Completion (Estimated): March 1, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: July 24, 2025
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 10, 2026

Study Record Updates

• Last Update Posted (Actual): February 10, 2026
• Last Update Submitted That Met QC Criteria: February 5, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: FMASU MD08/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No