Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis.
Vikas R Dharnidharka, Charles Kwon, Gary Stevens
https://pubmed.ncbi.nlm.nih.gov/12148093Actively Recruiting
Phase Not Applicable
Age: 18Years +
All Genders
Healthy Volunteers
ID07258875
Effect of VExUS Ultrasound Protocol on Fluid Management and the Incidence of Postoperative Pulmonary Complications and Acute Kidney Injury in Thoracic Surgery Patients
Led by University of Crete · Updated on 2025-12-02
230
Participants Needed
1
Research Sites
52 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating the impact of a VExUS ultrasound-guided fluid management protocol during thoracic surgery on the rates of postoperative lung complications and acute kidney injury. This study focuses on patients undergoing video-assisted thoracic surgery or lobectomy requiring one-lung ventilation, where fluid management is challenging due to risks like lung edema and kidney injury triggered by surgery and ventilation effects. The study aims to balance fluid administration to prevent both lung and kidney problems post-surgery. Participants are randomly assigned to one of two groups. The control group receives standard care with isotonic crystalloids at 3 mL/kg/h during surgery and recovery. The VExUS-guided group receives fluid management based on ultrasound assessments of venous congestion via the VExUS protocol, which measures inferior vena cava diameter and blood flow patterns in key veins to guide fluid and medication use. This includes tailored fluid boluses, diuretics, and fluid rates depending on congestion grades, and both groups receive treatment to replace blood losses and maintain hemoglobin levels. During the study, participants will undergo monitoring including invasive blood pressure, urine output, arterial blood gases, and respiratory parameters. Kidney function is assessed before surgery and on postoperative days 1 and 3 using filtration rates, biomarkers, and urine tests. Lung function and oxygen levels are measured preoperatively, during surgery, and after surgery. Researchers will track lung complications, kidney injury markers, fluid balance, and hemodynamic stability throughout hospitalization. The total participation duration covers preoperative assessment through the postoperative care unit and early recovery days.
CONDITIONS
Brief Title
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
Who Can Participate
Age: 18Years +
All Genders
Healthy Volunteers
Eligibility Criteria
You may qualify if you...
- Adults over 18 years undergoing video assisted thoracic surgery or lobectomy requiring one-lung ventilation
You will not qualify if you...
- Refusal to participate
- Pneumonectomy
- Young athletes with physiologically large inferior vena cava (IVC > 2 cm)
- Moderate to 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 units of packed red blood cells perioperatively (during surgery, PACU, or ward)
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Day of surgery
Participants undergo thoracic surgery with fluid management guided either by the VExUS ultrasound protocol or standard care. During surgery, fluid administration, anesthesia, and ventilation are managed with monitoring including ultrasound evaluations for those in the VExUS group. Postoperative care includes fluid management in the post-anesthesia care unit (PACU) and monitoring of kidney function and respiratory status.
1 day surgery visit and continuous monitoring in PACU
Post-operative Follow-up
Duration - 3 days
Participants are monitored postoperatively in the PACU and on postoperative days 1 and 3 for kidney function, respiratory status, and complications using blood tests, urine biomarkers, and oxygenation assessments.
Daily visits or assessments during PACU stay and on postoperative days 1 and 3
Trial Site Locations
Total: 1 location
1
University General Hospital of Heraklion
Heraklion, Crete, Greece, 71500
Actively Recruiting
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Research Team
A
Alexandros Bogas Manouselis, Resident of Anaesthesiology
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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Published Research Related To This Trial
Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures.
Ib Jammer, Nadine Wickboldt, Michael Sander...
https://pubmed.ncbi.nlm.nih.gov/25058504Correlation between the VExUS score and right atrial pressure: a pilot prospective observational study.
August Longino, Katharine Martin, Katarina Leyba...
https://pubmed.ncbi.nlm.nih.gov/37237315Venous Excess Ultrasound (VExUS Grading to Assess Perioperative Fluid Status for Noncardiac Surgeries: a Prospective Observational Pilot Study.
Justin C Magin, Jacob R Wrobel, Xinming An...
https://pubmed.ncbi.nlm.nih.gov/38099161Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system.
William Beaubien-Souligny, Philippe Rola, Korbin Haycock...
https://pubmed.ncbi.nlm.nih.gov/32270297Postoperative acute kidney injury.
S Romagnoli, Z Ricci
https://pubmed.ncbi.nlm.nih.gov/25057935Driving pressure-guided ventilation and postoperative pulmonary complications in thoracic surgery: a multicentre randomised clinical trial.
MiHye Park, Susie Yoon, Jae-Sik Nam...
https://pubmed.ncbi.nlm.nih.gov/35995638Lung Injury After One-Lung Ventilation: A Review of the Pathophysiologic Mechanisms Affecting the Ventilated and the Collapsed Lung.
Jens Lohser, Peter Slinger
https://pubmed.ncbi.nlm.nih.gov/26197368Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections.
Mustafa Kemal Arslantas, Hasan Volkan Kara, Beliz Bilgili Tuncer...
https://pubmed.ncbi.nlm.nih.gov/25304302Shear stress and the endothelial transport barrier.
John M Tarbell
https://pubmed.ncbi.nlm.nih.gov/20543206