VExUS ultrasound-guided fluid management during thoracic surgery with one-lung ventilation
Effect of VExUS Ultrasound Protocol (Venous Excess Ultrasound) on Perioperative Fluid Management, on the Incidence of Postoperative Pulmonary Complications and Postoperative Acute Kidney Injury in Patients Undergoing Thoracic Surgery
This trial will test whether using a VExUS ultrasound-guided goal-directed fluid plan during thoracic surgery with one-lung ventilation reduces postoperative lung complications and acute kidney injury.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 230 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Crete Academic / other |
| Drugs / interventions | chemotherapy, radiation |
| Locations | 1 site (Heraklion, Crete) |
| Trial ID | NCT07258875 on ClinicalTrials.gov |
What this trial studies
Perioperative fluid balance in thoracic surgery is challenging because too much fluid can cause lung edema while too little can cause hypoperfusion and kidney injury. In this interventional study, patients undergoing video-assisted thoracic surgery/lobectomy with one-lung ventilation will receive either a VExUS ultrasound–guided goal-directed fluid protocol or standard perioperative fluid care. The trial will track postoperative pulmonary complications and the occurrence of acute kidney injury, along with intraoperative fluid volumes and hemodynamic support. The study is conducted at the University General Hospital of Heraklion and excludes patients with severe cardiac, hepatic, or advanced renal disease and those undergoing pneumonectomy.
Who should consider this trial
Good fit: Adults over 18 undergoing video-assisted thoracic lobectomy with planned one-lung ventilation who do not meet exclusion criteria are the intended participants.
Not a fit: Patients with severe heart failure (EF <35%), significant tricuspid regurgitation or pulmonary hypertension, advanced liver disease or portal hypertension, stage 4+ CKD or dialysis, pneumonectomy, or large physiologic IVC (young athletes) are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the VExUS-guided approach could lower rates of postoperative pulmonary complications and acute kidney injury by better matching fluid administration to each patient's venous status.
How similar studies have performed: Ultrasound-guided and venous congestion (VExUS) approaches have shown promise in detecting venous overload and guiding fluids in other settings, but their use specifically for thoracic surgery and one-lung ventilation is novel with limited direct evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults \>18 years undergoing video assisted thoracic surgery/ lobectomy requiring one-lung ventilation. Exclusion Criteria: * Refusal to participate. * Pneumonectomy. * Young athletes (risk of physiologically large IVC \>2 cm). * Moderate-severe tricuspid regurgitation, moderate to severe pulmonary hypertension * Heart failure with reduced ejection fraction, EF\<35% * Portal hypertension, portal vein thrombosis, or liver cirrhosis. * Stage 4 or end-stage chronic kidney disease (eGFR \<30 mL/min/1.73 m² or dialysis). * Transfusion with more than 2 packed red blood cells unit perioperatively (intraoperatively, in the PACU, in the ward)
Where this trial is running
Heraklion, Crete
- University General Hospital of Heraklion — Heraklion, Crete, Greece (Recruiting)
Study contacts
- Study coordinator: Alexandros Bogas Manouselis, Resident of Anaesthesiology
- Email: bogas.alexandros@gmail.com
- Phone: +306947545446
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.