Health Condition 1: R579- Shock, unspecified
Conditions
Interventions
Intervention1: Fluid Responsiveness by Fluid Challenge: A Fluid challenge of 4ml/kg of predicted body weight will be infused over 1-2 Mins. Fluid bolus will be stopped in case of rapidly rising oxygen
Sponsors
Dr Ruchi Gupta
Eligibility
Inclusion criteria
Inclusion criteria: 1. More than or equal to 18 years of age on mechanical ventilation admitted in ICU 2. Clinical signs of shock, defined as any of the following: a.MAP less than 65mmHg b.Requiring vasopressors support to maintain MAP more than 65mmHg c.Lactate more than 2mmol per L d.Oliguria less than 0.5ml per kg per hour urine output e.Capillary refill time more than 5sec.
Exclusion criteria
Exclusion criteria: 1.Cardiac arrythmias 2.Moderate to severe valvular dysfunction 3.Poor echo window 4.Increased intraabdominal pressure 5.Large intra-abdominal masses or ascites causing IVC compression. 6.Right heart failure, acute Cor pulmonale 7.Patient not giving consent to get included in study. 8.Spontaneous breathing efforts (interferes with heart-lung interaction). 9.Severe obstructive airway diseases (e.g., COPD exacerbation, asthma with active bronchospasm).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To evaluate the predictive power of Pulse Pressure Variation (PPV) and the Distensibility Index of the Inferior Vena Cava (DIVC) in predicting fluid responsiveness in mechanically ventilated patients with undifferentiated shock.Timepoint: Before and after completion of fluid bolus. | — |
Secondary
| Measure | Time frame |
|---|---|
| To compare the predictive power of PPV and DIVC as dynamic parameters for prediction of fluid responsiveness among responders and non-responders.Timepoint: Pre fluid challenge;To analyze the changes in hemodynamic parameters after a fluid challenge and their association with fluid responsivenessTimepoint: pre and post fluid challenge;To assess the predictive performance of PPV and DIVC across subgroups, such as: 1.Septic vs. non-septic shock patients. 2.Patients with varying vasopressor (norepinephrine equivalent) requirements. Timepoint: prefluid challenge;To determine the impact of baseline clinical and hemodynamic variables, such as central venous pressure (CVP) and baseline vasopressor support, on fluid responsiveness.Timepoint: prefluid challenge;To validate the reliability of PPV and DIVC under varying clinical conditions, such as different driving pressures and PEEP levels, through subgroup analyses.Timepoint: prefluid challenge | — |
Countries
India
Contacts
Public ContactDr Sumit Ray
Holy Family Hospital
Outcome results
None listed