Intraoperative Carotid Peak Systolic Velocity Variability in Liver Transplant Patients (CPSV)

Evaluation of Intraoperative Carotid Peak Systolic Velocity Variability in Liver Transplant Patients

The aim of this study was to evaluate carotid peak systolic velocity variability using intraoperative ultrasound and to determine whether this method is useful in the assessment of hemodynamic status and intravascular volume in liver transplantation. Previously, a similar study was performed in liver transplant intensive care unit, but no study was performed to evaluate intraperative fluid status with carotid ultrasonography.

Study Overview

• Status: Completed
• Conditions: Liver Transplant Disorder

Detailed Description

Aim: The aim of this study was to evaluate carotid peak systolic velocity variability using intraoperative ultrasound and to determine whether this method is useful in the assessment of hemodynamic status and intravascular volume in liver transplantation. Previously, a similar study was performed in liver transplant intensive care unit, but no study was performed to evaluate intraperative fluid status with carotid ultrasonography.

Material and Method: Our prospective, single-center study was conducted at the Inonu University Faculty of Medicine, Turgut Ozal Medical Center Liver Transplant Institute, between Semtember 18, 2023, and April 29, 2024. After excluding patients with fulminant hepatic failure requiring emergency transplantation and those outside the age range of 18-65 years, 42 patients out of a total of 89 liver transplant recipients were included. Masimo non-invasive probe was inserted for pleth variable index (PVI), perfusion index (PI), oxygen reserve index (ORI), SpHb measurement and input values were recorded. After invasive arterial monitoring, which is routinely performed in transplant patients, cardiac output, stroke volume, stroke volume variation, dPmax were monitored by pulse contour analysis method and values were recorded. At the beginning of the dissection phase, carotid ultrasound was performed and values were recorded (T0). After the portal vein and v. cava inf. were clamped (anhepatic period), carotid ultrasound was performed and values were recorded (T1). Hemodynamic, respiratory, routine laboratory data and hourly urine output were recorded throughout the operation.

• Study Type: Observational
• Enrollment (Actual): 42

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Turkey
    • Malatya, Turkey, Turkey (Türkiye), 44280
      • İnönü Üniversitesi Merkez Kampüsü (Elazığ Yolu 15.km) Battalgazi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Liver transplant recipients received at İnönü University Liver Transplant Institute between 18.09.2023 and 29.04.2024

Description

Inclusion Criteria:

• Adult patients scheduled for elective liver transplantation

Exclusion Criteria:

• fulminant hepatic failure requiring emergency transplantation, patients with carotid artery disease

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Liver transplant recipients; After excluding patients with fulminant hepatic failure requiring emergency transplantation and those outside the age range of 18-65 years, 42 patients out of a total of 89 liver transplant recipients were included.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
CPSVv	carotid peak systolic velocity variability	During surgery: T0: Before vena cava inferior clamping T1: After vena cava inferior clamping

Collaborators and Investigators

• Sponsor: Inonu University

Publications and helpful links

General Publications

• Ibarra-Estrada MA, Lopez-Pulgarin JA, Mijangos-Mendez JC, Diaz-Gomez JL, Aguirre-Avalos G. Respiratory variation in carotid peak systolic velocity predicts volume responsiveness in mechanically ventilated patients with septic shock: a prospective cohort study. Crit Ultrasound J. 2015 Dec;7(1):29. doi: 10.1186/s13089-015-0029-1. Epub 2015 Jun 26.
• Roy A, Pachisia AV, Govil D, Kn J, Patel S, Harne R, Pal D, Reddy DM, Tyagi P, Pattajoshi S. Fluid Responsiveness in Critically Ill Patients Using Carotid Peak Systolic Velocity Variability: A New Frontier. Cureus. 2023 Jul 18;15(7):e42083. doi: 10.7759/cureus.42083. eCollection 2023 Jul.
• Ramsingh D, Staab J, Flynn B. Application of perioperative hemodynamics today and potentials for tomorrow. Best Pract Res Clin Anaesthesiol. 2021 Dec;35(4):551-564. doi: 10.1016/j.bpa.2021.01.005. Epub 2021 Feb 4.

Study record dates

Study Major Dates

• Study Start (Actual): September 18, 2023
• Primary Completion (Actual): April 29, 2024
• Study Completion (Actual): January 10, 2025

Study Registration Dates

• First Submitted: May 21, 2025
• First Submitted That Met QC Criteria: February 24, 2026
• First Posted (Actual): March 2, 2026

Study Record Updates

• Last Update Posted (Actual): March 2, 2026
• Last Update Submitted That Met QC Criteria: February 24, 2026
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: Inonu CPSV

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: We do not have the necessary infrastructure

Drug and device information, study documents

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