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

4. juni 2026 opdateret af: 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.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

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.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

150

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

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

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

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.

Beskrivelse

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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
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.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Post-induction hypotension
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Postoperative Acute Kidney Injury
Tidsramme: 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
Tidsramme: Induction to End of Surgery
Total duration of mean arterial pressure threshold of 65 mmHg during the operative period
Induction to End of Surgery

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cummulative Intra-operative Hypotension burden
Tidsramme: Induction to End of surgery
Area under the mean arterial pressure threshold of 65 mmHg during the operative period
Induction to End of surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Tîrgu Mureș Emergency Clinical County Hospital, Romania

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

31. januar 2027

Studieafslutning (Anslået)

28. marts 2027

Datoer for studieregistrering

Først indsendt

21. maj 2026

Først indsendt, der opfyldte QC-kriterier

4. juni 2026

Først opslået (Faktiske)

10. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 7979

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