This study investigates the role of respiratory variation in the internal jugular vein as a tool for intraoperative fluid management during abdominal surgeries under general anesthesia.
The purpose of this clinical trial is to reduce postoperative complications and improve patient outcomes through proper intraoperative fluid management.
The main question it aims to answer is: Can intraoperative fluid management guided by the respiratory variation of the internal jugular vein during abdominal surgeries reduce postoperative complications? Research Hypothesis (Alternative Hypothesis): We hypothesize that fluid management guided by the respiratory variation of the internal jugular vein during abdominal surgeries can reduce postoperative complications.
The patients will be divided into two groups and randomized to receive either intraoperative fluid therapy guided by the respiratory variation of the internal jugular vein or standard fluid therapy. Postoperative complications, length of hospital stay, total amount of fluid administered intraoperatively, use of vasopressors in both groups, and incidence of hypotensive episodes will be recorded.
Patients' American Society of Anesthesiologists physical status (ASA) is I and II.
The target age group is 20 to 70 years old.
Patients scheduled for abdominal surgery under general anesthesia with normal renal function.
Refusal of the procedure or participation in the study.
Coagulopathy.
Pre-existing cardiac, renal, and respiratory diseases. 4-Internal jugular vein thrombosis
Parallel
Respiratory variation of the Internal Jugular Vein (IJV)
Diagnostic testIn the study group, the fluid therapy will be guided by the respiratory variation (RV) of the Internal Jugular Vein (IJV) throughout surgery. Fluid maintenance will be continued as long as the IJV diameter is less than 2 cm and the IJV RV is more than 18. If the IJV diameter exceeds 2 cm and the IJV RV is less than 18, fluids will be stopped.
The primary outcome is the incidence of postoperative complications in both groups, which will be measured by the occurrence of any of the postoperative complications during the first seven postoperative days in both groups
Postoperative complications will include: (i) infections (urinary tract infection, wound infection, sepsis/septic shock) (ii) GI (Ileus, acute bowel obstruction, GI bleeding, abdominal compartment syndrome), (iii) Cardiovascular (deep venous thrombosis, pulmonary embolism, myocardial ischemia or infarction, cardiac arrest), (iv) Renal (AKI) (v) Respiratory (pneumonia, prolonged mechanical ventilation (more than 24 hours), respiratory failure, ARDS).
The length of hospital stay in both groups
Assessment of the total amount of fluid administered intraoperatively in both groups
Intraoperative vasopressor use in both groups
Intraoperative hypotensive episodes in both groups
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