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Assessment of Renal Perfusion Using Ultrasound and Near-Infrared Spectroscopy in Patients Undergoing Minimally Invasive Abdominal Surgery (RRI-NIRS)

2026年6月3日 更新者:Lyudmila Martynenko Aydogdu、Istanbul University - Cerrahpasa

Prospective Observational Evaluation of Renal Perfusion Using Doppler Ultrasonography and Near-Infrared Spectroscopy in Patients Undergoing Elective Minimally Invasive Abdominal Surgery

This prospective observational study aims to evaluate renal perfusion in adult patients undergoing elective minimally invasive abdominal surgery. Renal perfusion will be assessed using two non-invasive monitoring techniques: Doppler ultrasonography-derived Renal Resistive Index (RRI) and Near-Infrared Spectroscopy (NIRS)-derived renal regional oxygen saturation (rSO₂).

Measurements will be obtained at predefined perioperative time points, including after induction of anesthesia, during pneumoperitoneum, before extubation, and during the early postoperative period. Perioperative changes in renal perfusion parameters will be analyzed and correlated with clinical variables such as intra-abdominal pressure, pneumoperitoneum duration, hemodynamic parameters, fluid administration, urine output, and postoperative renal function.

The study also aims to investigate the relationship between intraoperative renal perfusion changes and the development of postoperative acute kidney injury. The findings may contribute to improved perioperative monitoring and optimization of renal perfusion during minimally invasive abdominal surgery.

調査の概要

詳細な説明

Minimally invasive abdominal surgery has become increasingly common because of reduced surgical trauma, faster recovery, and lower postoperative morbidity compared with conventional open surgery. However, laparoscopic procedures require the creation of pneumoperitoneum, which may increase intra-abdominal pressure and adversely affect renal blood flow, renal oxygen delivery, and kidney function.

Renal hypoperfusion during surgery may contribute to postoperative renal dysfunction and acute kidney injury (AKI). Traditional indicators of renal injury, such as serum creatinine and urine output, often fail to detect early changes in renal perfusion. Therefore, reliable non-invasive methods for real-time assessment of renal perfusion are needed.

Doppler ultrasonography-derived Renal Resistive Index (RRI) and Near-Infrared Spectroscopy (NIRS)-derived regional renal oxygen saturation (rSO₂) are promising techniques for evaluating renal perfusion and oxygenation. Both methods provide non-invasive, bedside assessment and may allow early detection of perfusion abnormalities before conventional markers become abnormal.

This prospective single-center observational study will evaluate perioperative renal perfusion in adult patients undergoing elective minimally invasive abdominal surgery. Renal perfusion measurements will be obtained using Doppler ultrasonography and NIRS at predefined perioperative time points, including after induction of anesthesia, during pneumoperitoneum, before extubation, and during the early postoperative period.

Demographic characteristics, comorbidities, baseline renal function, intraoperative hemodynamic variables, pneumoperitoneum duration and pressure, fluid administration, urine output, blood loss, ventilatory parameters, and postoperative renal function will be recorded. Associations between perioperative renal perfusion parameters and postoperative renal outcomes, including acute kidney injury, will be investigated.

The findings of this study may improve understanding of perioperative renal perfusion changes during minimally invasive abdominal surgery and contribute to the development of strategies for optimizing renal protection and perioperative patient management

研究の種類

観察的

入学 (推定)

51

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

      • Istanbul、トルコ(Türkiye)、34320
        • 募集
        • Istanbul University Cerrahpasa Faculty of Medicine
        • コンタクト:

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

非確率サンプル

調査対象母集団

Adult patients aged 18-80 years with ASA physical status I-III undergoing elective minimally invasive abdominal surgery at Istanbul University-Cerrahpaşa Faculty of Medicine. Patients will be prospectively evaluated for perioperative renal perfusion using Doppler ultrasonography and Near-Infrared Spectroscopy (NIRS).

説明

Inclusion Criteria:

  • Patients aged 18 to 80 years
  • Patients with ASA physical status I, II, or III
  • Patients undergoing elective minimally invasive abdominal surgery for any reason
  • Patients whose expected surgical duration is longer than 1 hour

Exclusion Criteria:

  • Body mass index greater than 35 kg/m²
  • Severe respiratory system disease
  • Severe heart failure, NYHA class III-IV
  • Presence of a cardiac pacemaker or cardiac defibrillator implant
  • Progressive neuromuscular disease
  • High intra-abdominal pressure
  • Sudden deterioration of general condition
  • Incomplete clinical or laboratory data
  • Refusal to participate in the study
  • Conversion to open surgery

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
Elective Minimally Invasive Abdominal Surgery Patients
Adult patients aged 18 to 80 years undergoing elective minimally invasive abdominal surgery under general anesthesia. Renal perfusion will be assessed perioperatively and postoperatively(postoperative 1. hour) using Doppler ultrasonography-derived Renal Resistive Index (RRI) and Near-Infrared Spectroscopy (NIRS)-derived regional renal oxygen saturation (rSO₂). Measurements will be performed at predefined perioperative time points and correlated with intraoperative variables, postoperative renal function, and the occurrence of acute kidney injury.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in Renal Regional Oxygen Saturation Measured by NIRS
時間枠:after endotracheal intubation, immediately before extubation, and 1 hour after extubation
Renal regional oxygen saturation (rSO₂) will be measured bilaterally using Near-Infrared Spectroscopy (NIRS). NIRS values will be recorded at predefined perioperative time points.
after endotracheal intubation, immediately before extubation, and 1 hour after extubation
Change in Renal Resistive Index
時間枠:after endotracheal intubation, immediately before extubation, and 1 hour after extubation
Renal Resistive Index (RRI) measured by Doppler ultrasonography at predefined perioperative time points. RRI will be calculated from peak systolic velocity and end-diastolic velocity obtained from renal interlobar or arcuate arteries.
after endotracheal intubation, immediately before extubation, and 1 hour after extubation

二次結果の測定

結果測定
メジャーの説明
時間枠
Relationship Between Renal Resistive Index and Renal Regional Oxygen Saturation
時間枠:after endotracheal intubation, immediately before extubation, and 1 hour after extubation
The relationship between renal Doppler ultrasonography-derived Renal Resistive Index (RRI) and NIRS-derived renal regional oxygen saturation (rSO₂) will be evaluated for the right and left kidneys at predefined perioperative measurement time points.
after endotracheal intubation, immediately before extubation, and 1 hour after extubation

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年1月7日

一次修了 (推定)

2027年1月7日

研究の完了 (推定)

2027年1月7日

試験登録日

最初に提出

2026年6月3日

QC基準を満たした最初の提出物

2026年6月3日

最初の投稿 (実際)

2026年6月9日

学習記録の更新

投稿された最後の更新 (実際)

2026年6月9日

QC基準を満たした最後の更新が送信されました

2026年6月3日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

Individual participant data (IPD) will not be shared because the study was not designed with a data-sharing plan and participant confidentiality will be protected in accordance with institutional and ethical requirements.

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いいえ

米国FDA規制機器製品の研究

いいえ

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