Internal Jugular Vein Ultrasound and Acute Kidney Injury After Abdominal Surgery (PRO-JUGULAR)

June 4, 2026 updated by: Matild Keresztes, Tîrgu Mureș Emergency Clinical County Hospital, Romania

Dynamic Internal Jugular Vein Assessment During Anesthesia Induction as a Predictor of Hemodynamic Instability and Postoperative Outcomes

The goal of this observational study is to learn whether changes in the internal jugular vein during anesthesia induction can help predict low blood pressure and kidney injury after surgery. The main questions it aims to answer are:

  1. Can the internal jugular vein collapsibility index before anesthesia predict low blood pressure during induction?
  2. Can the change in internal jugular vein collapsibility from before to just after anesthesia predict low blood pressure during surgery and acute kidney injury after surgery?

Participants will have routine ultrasound scans of the neck before anesthesia and again shortly after they fall asleep for surgery. Researchers will also record blood pressure during surgery and measure kidney function after surgery using routine blood tests.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a single-center prospective observational study in adults undergoing major abdominal or visceral surgery under general anesthesia. The study is designed to see whether bedside ultrasound measurements of the internal jugular vein can help identify participants who are at risk of low blood pressure during anesthesia induction and acute kidney injury after surgery.

Participants will have one ultrasound scan while awake before anesthesia and a second scan shortly after loss of consciousness following propofol induction. The researchers will calculate the internal jugular vein collapsibility index from both scans and determine the change between them. They will then compare these measurements with blood pressure changes during the induction period and with postoperative kidney function, which will be assessed using routine creatinine tests.

The study includes adults age 18 years and older who are having elective or urgent non-emergency major abdominal or visceral surgery. Participants must receive propofol for anesthesia induction and must have blood pressure monitoring during surgery. People with emergency surgery, dialysis dependence, major anatomic problems that prevent ultrasound scanning of the neck, or other conditions that would make the ultrasound measurement invalid will not be included.

The study does not change routine anesthesia care. The ultrasound scans and blood tests are added only for research purposes, and the results are intended to help predict risk rather than guide treatment during the study itself.

Study Type

Observational

Enrollment (Estimated)

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Romania
    • Mureș County
      • Târgu Mureş, Mureș County, Romania, 540136
        • County Emergency Clinical Hospital of Targu Mureș

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

The study population consists of adults aged 18 years and older undergoing major abdominal or visceral surgery under general anesthesia with propofol induction at the Department of Anestesiology and Intensive Care Department in the Emergency County Hospital in Târgu Mureș. Patients will be enrolled prospectively in the preoperative period if they meet eligibility criteria, have routine perioperative blood pressure monitoring, and are able to undergo internal jugular vein ultrasound before and immediately after induction. The cohort will be followed through postoperative days 1 to 3 for creatinine-based assessment of acute kidney injury.

Description

Inclusion Criteria:

  • Elective or Urgent (Non-emergent) major abdominal/ visceral surgery under general anesthesia
  • General anesthesia with propofol induction (TCI/ manual)
  • Expected surgical duration > 60 minutes
  • Continous BP monitoring (Invasive arterial line or non-invasive cuff at 2 minute recording intervals)
  • Serum creatinine and eGFR (CKD-EPI) available within 30 days prior to surgery
  • Written informed consent obtained before surgery
  • Patient accessible by phone 30 days postoperatively

Exclusion Criteria:

  • Emergency surgery (immediate life-saving, consent unobtainable)
  • End-stage renal disease (eGFR < 15 mL/min/1.73 m²) or dialysis-dependent
  • Concomitant cardiac surgery or carotid endarterectomy
  • Liver transplantation
  • Known Internal Jugular Vein/ Inferior Vena Cava thrombosis or Superior Vena Cava syndrome
  • Any anatomical neck abnormalities precluding Internal jugular vein ultrasound
  • Induction with ketamine or etomidate as sole Induction agent
  • Neuraxial anesthesia (spinal or epidural) before propofol induction
  • Active decompensated heart failure (NYHA IV or acute pulmonary edema at time of Surgery)
  • Same-admission reoperation within 30-day study window
  • Withdrawal of consent at any point

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Propofol Peri-induction IJV cohort
Prospective observational cohort of adult patients undergoing elective or urgent non-emergent major abdominal or visceral surgery under general anesthesia with propofol induction. Participants will undergo pre-induction and immediate post-induction internal jugular vein ultrasound measurements to evaluate whether changes in internal jugular vein collapsibility predict post-induction hypotension and postoperative acute kidney injury.
Procedure: Internal Jugular Vein Ultrasound Assesment
Point-of-care Internal jugular vein ultrasound performed before induction and immediately after propofol induction to measure vein diameter and collapsibility index.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-induction hypotension
Time Frame: Periprocedural
Incidence of mean arterial pressure below 65 mmHg for atleast one consecutive minute during propofol induction
Periprocedural
Change in Internal Jugular Vein Collapsibility Index
Time Frame: From pre-induction to immediate post-induction
Difference between pre-induction and immediate post-induction internal jugular vein collapsibility index measured by point-of-care ultrasound
From pre-induction to immediate post-induction

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Acute Kidney Injury
Time Frame: Postoperative days one to three
Acute Kidney Injury defined according to KDIGO criteria based on postoperative serum creatinine measurements
Postoperative days one to three
Cumulative Intra-operative Hypotension Burden
Time Frame: Induction to End of Surgery
Total duration of mean arterial pressure threshold of 65 mmHg during the operative period
Induction to End of Surgery

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cummulative Intra-operative Hypotension burden
Time Frame: Induction to End of surgery
Area under the mean arterial pressure threshold of 65 mmHg during the operative period
Induction to End of surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tîrgu Mureș Emergency Clinical County Hospital, Romania

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

January 31, 2027

Study Completion (Estimated)

March 28, 2027

Study Registration Dates

First Submitted

May 21, 2026

First Submitted That Met QC Criteria

June 4, 2026

First Posted (Actual)

June 10, 2026

Study Record Updates

Last Update Posted (Actual)

June 10, 2026

Last Update Submitted That Met QC Criteria

June 4, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 7979

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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