Using internal jugular vein ultrasound to guide fluids during abdominal surgery

Effect of Intraoperative Fluid Management Guided by Respiratory Variations of Internal Jugular Vein on Postoperative Complications in Abdominal Surgeries: A Prospective Randomized Controlled Trial

This trial will try using ultrasound measurements of breathing-related changes in the internal jugular vein to guide how much fluid adults aged 20–70 receive during abdominal surgery and see if that lowers postoperative complications.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 84 (estimated)
• Ages: 20 Years to 70 Years
• Sex: All
• Sponsor: Suez Canal University (Academic / other)
• Locations: 2 sites (Ismailia, Ismailia Governorate and 1 other locations)
• Trial ID: NCT07041021 on ClinicalTrials.gov

What this trial studies

Adults undergoing abdominal surgery under general anesthesia are randomized to receive intraoperative fluid therapy guided by respiratory variation of the internal jugular vein measured by ultrasound or to receive standard fluid therapy. A trained anesthesiologist will obtain left IJV M-mode measurements at the cricoid level using a Philips CX50 and calculate IJV respiratory variation from three respiratory cycles to guide fluid decisions. The ultrasound operator is not involved in anesthesia management and is separated from monitors to maintain blinding of hemodynamic data while clinicians follow the allocated fluid protocol intraoperatively. Postoperative complications and length of hospital stay are compared between groups to determine whether IJV-guided fluid management reduces adverse events.

Who should consider this trial

Good fit: Adults aged 20–70 with ASA physical status I–II and normal renal function scheduled for abdominal surgery under general anesthesia, without pre-existing cardiac, renal, or respiratory disease, coagulopathy, or internal jugular vein thrombosis.

Not a fit: Patients with significant cardiac, renal, or respiratory disease, coagulopathy, internal jugular vein thrombosis, ASA III or higher, or those outside the 20–70 age range are unlikely to be eligible or to benefit from this protocol.

Why it matters

Potential benefit: If successful, this approach could reduce postoperative complications and shorten hospital stay by tailoring intraoperative fluids to each patient's volume status.

How similar studies have performed: Physiologic and small clinical studies using respiratory variation of central or inferior vena cava veins support the concept of dynamic venous indices to guide fluids, but large randomized trials showing reduced postoperative complications specifically using IJV variation are limited.

Eligibility criteria

Inclusion Criteria:

1. Patients' American Society of Anesthesiologists physical status (ASA) is I and II.
2. The target age group is 20 to 70 years old.
3. Patients scheduled for abdominal surgery under general anesthesia with normal renal function.

Exclusion Criteria:

1. Refusal of the procedure or participation in the study.
2. Coagulopathy.
3. Pre-existing cardiac, renal, and respiratory diseases. 4-Internal jugular vein thrombosis

Where this trial is running

Ismailia, Ismailia Governorate and 1 other locations

• Suez Canal University Hospitals — Ismailia, Ismailia Governorate, Egypt (Not_yet_recruiting)
• Suez Canal University Hospitals — Ismailia, Egypt (Recruiting)

Study contacts

• Principal investigator: Mohammad E Salama, MD — Suez canal university hospitals
• Study coordinator: Mohammad E Salama, MD

Conditions Postoperative Complications; Abdominal surgeries; Internal Jugular Vein; Intraoperative fluid therapy