Cardiopulmonary Diseases, Sepsis, Shock, ARDS
Conditions
Interventions
Group 1: This monocentric, prospective observational study aims to evaluate whether routine focused transthoracic echocardiography (TTE) upon unplanned ICU admission facilitates the detection of clini
Sponsors
Klinikum Fürth, Klinik für Anästhsie, Operative Intensivmedizin und Schmerztherapie
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: - Unplanned admission to the intensive care unit - Patient or caregiver is able to sign the consent - Signed informed consent
Exclusion criteria
Exclusion criteria: - Missing consent - Non-consentable patients for whom no caregiver is available - Echocardiogramm due to the same indication on the same day of admission to the intensive care unit
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary Endpoint of the Study: • What? The primary endpoint is the frequency of pathological echocardiographic findings that lead to a relevant change in intensive care management. • When? The primary endpoint is determined within 24 hours after focused transthoracic echocardiography (TTE). • How? Measurement Method: - TTE findings are systematically recorded in the case report form (CRF) using predefined parameters (e.g., EF, TAPSE, PAPsys, pericardial effusion, pleural effusion, volume status, valvular pathologies). - It is documented whether a pathological finding was detected. Documentation & Evaluation: - The documented findings are compared with subsequent intensive care measures. - A therapy adjustment is only considered relevant if it is directly attributable to the TTE findings. Clinical Measures Following TTE: - Modified ventilation strategy (e.g., transition to ITN/NIV/High-Flow or modification of PEEP settings). - Advanced hemodynamic monitoring (e.g., insertion of a central venous catheter, pulse contour analysis). - Initiation or modification of catecholamine therapy (norepinephrine, dobutamine, adrenaline). - Indication for further diagnostics (e.g., CT, chest X-ray, laboratory parameters such as troponin or D-dimers). - Indication for therapeutic interventions (e.g., pleural puncture, pericardial puncture, diuretic therapy, volume administration, afterload reduction, right heart unloading, cardioversion) Statistical Analysis of the Primary Endpoint: • The rate of pathological echocardiographic findings will be reported as absolute and relative frequency. • The number of patients with a therapy adjustment based on these findings will also be recorded. • Comparison of patients with and without pathological findings regarding changes in clinical therapy (Chi-square test or Fisher’s exact test for categorical data). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary Endpoints and Their Assessment: 1. Change in Ventilation Regimen Due to TTE Findings - When? Within 24 hours after TTE - How? Documentation of whether the type of ventilation changed due to TTE results: - Transition between ITN, NIV, High-Flow, O2 insufflation - Adjustment of ventilation parameters (e.g., PEEP, FiO2) 2. Expansion of Hemodynamic Monitoring Due to TTE Findings - When? Within 24 hours after TTE - How? Recording of additional monitoring measures performed: - Arterial access - Placement of a central venous catheter - Pulse contour analysis - Indication for transesophageal echocardiography 3. Modification of Catecholamine Therapy Due to TTE Findings - When? Within 24 hours after TTE - How? Comparison between planned and actual catecholamine therapy: Norepinephrine, dobutamine, adrenaline (newly initiated or dose modified) 4. Indication for Further Diagnostics Due to TTE Findings - When? Within 24 hours after TTE -How? Comparison between planned and conducted diagnostics (e.g., CT, chest X-ray, troponin, D-dimers, blood culture, PCT, extended sonography) 5. Indication for Therapeutic Interventions Due to TTE Findings - When? Within 24 hours after TTE - How? Documentation of planned vs. performed interventions: - Pleural puncture - Pericardial puncture - Coronary angiography - CPAP - Administration of diuretics/fluids - Anticoagulation / preload or afterload reduction Statistical Analysis of Secondary Endpoints: • Comparison of patients with and without therapy adjustment due to TTE findings • Descriptive analysis (absolute and relative frequencies) • Group comparison using Chi-square test or Fisher’s exact test | — |
Countries
Germany
Contacts
Public ContactChristoph Raspé
Klinikum Fürth, Klinik für Anästhsie, Operative Intensivmedizin und Schmerztherapie
Outcome results
None listed