SV and IVC Collapsibility Index to Predict Postinduction Hypotension

Stroke Volume Versus Inferior Vena Cava Collapsibility Index to Predict Postinduction Hypotension in Intestinal Obstruction

Postinduction hypotension (PIH) is a frequent complication during general anesthesia. This study aims to compare the predictive effectiveness and diagnostic accuracy of stroke volume (SV) measured via left ventricular outflow tract velocity time integral (LVOT-VTI) versus the inferior vena cava collapsibility index (IVC-CI) using transthoracic echocardiography. The assessment will be conducted in adult patients with intestinal obstruction undergoing exploratory abdominal surgery under general anesthesia.

Study Overview

• Status: Not yet recruiting
• Conditions: Intestinal Obstruction; Post-induction Hypotension

Detailed Description

Postinduction hypotension (PIH) is associated with adverse postoperative outcomes. In this diagnostic accuracy observational study, adult patients aged 40-70 years with intestinal obstruction undergoing exploratory abdominal surgery under general anesthesia will be enrolled at Ain Shams University Hospitals. Prior to induction of general anesthesia, transthoracic echocardiography (TTE) will be performed to measure the stroke volume (SV) via LVOT-VTI and the inferior vena cava collapsibility index (IVC-CI). Patients will receive standard rapid sequence induction, and hemodynamic parameters will be monitored post-induction to evaluate the predictive value, sensitivity, and specificity of SV versus IVC-CI for postinduction hypotension. Secondary outcomes including incidence of PIH, length of hospital stay, PACU recovery time, and postoperative nausea and vomiting will also be recorded.

• Study Type: Observational
• Enrollment (Estimated): 75

Contacts and Locations

• Study Contact: Name: Noura A Kamal, M.Sc.; Phone Number: +201119774236; Email: NouraAbdel-Monem@med.asu.edu.eg
• Study Contact Backup: Name: Islam A Taher, M.D.; Phone Number: +201005629809

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Adult patients diagnosed with intestinal obstruction scheduled for exploratory abdominal surgery under general anesthesia at Ain-Shams University Hospitals.

Description

Inclusion Criteria:

• Adult patients with intestinal bowel obstruction undergoing exploratory abdominal surgery under general anesthesia.
• Age 40 to 70 years old.
• Body Mass Index (BMI) = 18 to 25 kg/m2.
• American Society of Anesthesiologists (ASA) physical status grade I or II.

Exclusion Criteria:

• American Society of Anesthesiologists (ASA) physical status grade >= III.
• Patients in whom the IVC cannot be visualized or patients with poor echogenicity.
• Patients with hemodynamic instability.
• Patients with vascular, respiratory, or cardiac diseases (e.g., cardiomyopathy, heart valve disease, arrhythmia, or bad exercise tolerance).
• Pregnant patients.
• Difficult airway or multiple intubatio

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diagnostic accuracy of Stroke Volume (SV) to predict post-induction hypotension.	Area under the receiver operating characteristic curve (AUC) of stroke volume measured via left ventricular outflow tract velocity-time integral (LVOT-VTI) as a predictor of post-induction hypotension.	Baseline (pre-induction) and immediately post-induction.
Diagnostic accuracy of Inferior Vena Cava Collapsibility Index (IVC-CI) to predict post-induction hypotension.	Area under the receiver operating characteristic curve (AUC) of inferior vena cava collapsibility index measured via transthoracic echocardiography (TTE) as a predictor of post-induction hypotension.	Baseline (pre-induction) and immediately post-induction.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of Hospital Stay Length of Hospital Stay	Total duration of hospitalization from the day of surgery until discharge.	From date of surgery until hospital discharge (up to 9 months).
Time to Recovery from Post-Anesthesia Care Unit (PACU) Time to Recovery from Post-Anesthesia Care Unit (PACU)	Time elapsed from patient admission to the PACU until meeting discharge criteria. Time elapsed from patient admission to the PACU until meeting discharge criteria.	Intraoperative / immediate postoperative period until PACU discharge (up to 24 hours).
Incidence of Post-Induction Hypotension	Assessment of the proportion of patients who develop post-induction hypotension, defined as SBP decrease > 30%, MAP decrease > 20% from baseline, or absolute SBP < 90 mmHg and MAP < 60 mmHg.	Within 3 minutes following induction of general anesthesia.

Collaborators and Investigators

• Sponsor: Ain Shams University
• Investigators: Study Chair: Mohamed H Shokeir, M.D., Ph.D., Ain Shams University

Study record dates

Study Major Dates

• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): February 1, 2027

Study Registration Dates

• First Submitted: July 29, 2026
• First Submitted That Met QC Criteria: July 29, 2026
• First Posted (Actual): August 3, 2026

Study Record Updates

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

More Information

Terms related to this study

• Keywords: Echocardiography; Stroke Volume; General Anesthesia; Inferior Vena Cava Collapsibility Index; LVOT-VTI
• Additional Relevant MeSH Terms: Intestinal Diseases; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Obstruction
• Other Study ID Numbers: FMASU MD49/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared to protect patient privacy and confidentiality.

Drug and device information, study documents

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