Predicting low blood pressure after anesthesia in older adults using carotid cFT and IVC collapsibility

Carotid Artery Corrected Flow Time and Inferior Vena Cava Collapsibility Index for Prediction of Hypotension After Induction of General Anesthesia in Geriatric Patients Undergoing Elective Surgery

We will test whether two ultrasound measurements—carotid corrected flow time (cFT) and the inferior vena cava (IVC) collapsibility index—can predict which older adults having elective surgery will develop low blood pressure after induction of general anesthesia.

Quick facts

• Study type: Observational
• Enrollment: 189 (estimated)
• Ages: 65 Years and up
• Sex: All
• Sponsor: Tanta University (Academic / other)
• Locations: 1 site (Tanta, El Gharbyia)
• Trial ID: NCT06814054 on ClinicalTrials.gov

What this trial studies

This is an observational study in which clinicians will perform carotid ultrasound to measure corrected flow time and abdominal ultrasound to determine IVC collapsibility before induction of general anesthesia in geriatric patients. Blood pressure will be monitored immediately after induction, and hypotension will be defined by a 30% drop in SBP or 20% drop in MAP from baseline, or an absolute SBP < 90 mmHg or MAP < 65 mmHg within 3 minutes. Patients included are ASA physical status I–II undergoing elective surgery who have fasted 6–8 hours, while those with significant comorbidities (ASA III–IV, arrhythmia, COPD, BMI > 30, peripheral arterial disease) are excluded. The preinduction ultrasound measurements will be compared with the occurrence of postinduction hypotension to determine predictive performance.

Who should consider this trial

Good fit: Older adults scheduled for elective surgery under general anesthesia who are ASA I–II, have fasted 6–8 hours, and do not have major cardiac, respiratory, or vascular comorbidities.

Not a fit: Patients with ASA III–IV, arrhythmias, cardiomyopathy, COPD, BMI > 30 kg/m2, significant peripheral arterial disease, extreme baseline blood pressures, or those who experience difficult intubation or desaturation during induction are unlikely to benefit from these measures in this protocol.

Why it matters

Potential benefit: If successful, these noninvasive ultrasound measures could help identify older patients at risk for post-induction hypotension so clinicians can adjust fluid or anesthetic management to reduce organ injury.

How similar studies have performed: Previous work, including reports by Zhang and Critchley, has shown that IVC diameter and collapsibility can predict postinduction hypotension, while carotid corrected flow time has shown some promising but less widely validated results.

Eligibility criteria

Inclusion Criteria:

* American Society of Anaesthesiologists Physical Status I to Ⅱ
* receiving general anesthesia for elective surgery
* fasted for at least 6 to 8 hours were recruited in this study

Exclusion Criteria:

* • patients who refused to participate in the study

  * American Society of Anaesthesiologists Physical Status Ⅲ or Ⅳ
  * Patients with a history of peripheral arterial diseases or atherosclerosis
  * Patients with body mass index of greater than 30 kg/m2
  * Patients with arrhythmia or cardiomyopathy
  * Chronic obstructive pulmonary disease (COPD)
  * baseline systolic arterial pressure (SAP) ≥ 180 mmHg or \< 90mmHg
  * Any episode of desaturation or difficult intubation during general anasethia induction

Where this trial is running

Tanta, El Gharbyia

• Faculty of medicine, Tanta university — Tanta, El Gharbyia, Egypt (Recruiting)

Study contacts

• Principal investigator: tarek Mostafa — tanta university, faculty of medicine
• Study coordinator: tarek AH Mostafa

Conditions Geriatrics; Hypotension on Induction; General Anesthetic Drug Adverse Reaction; Elective Surgery