Hypotension, Shock
Conditions
Keywords
Fluid responsiveness, Ultrasound, Cardiac output
Brief summary
The investigators designed this study to determine the predictive value for predicting fluid responsiveness of noninvasive evaluation of respiratory variation of peak velocity in brachial artery, in mechanically ventilated patients with acute circulatory failure.
Detailed description
Predicting the hemodynamic response to fluid administration (or fluid responsiveness) in critical ill patients is still a matter of concern, since fluid overload could worse the clinical situation of these patients. Parameters of fluid responsiveness usually require an invasive monitoring (like arterial pulse pressure variation). We hypothesize that noninvasive evaluation of respiratory variation of peak velocity in brachial artery using Doppler ultrasound could provide a feasible estimation on fluid responsiveness in mechanically ventilated patients with acute circulatory failure.
Interventions
OTHERFluid administration
500 ml of synthetic colloid (Voluven®, hydroxyethylstarch 6%; Fresenius, Bad Homburg, Germany) infused over 30 minutes
Sponsors
Hospital del SAS de Jerez
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with controlled mechanical ventilation, equipped with an indwelling radial artery catheter and for whom the decision to give fluids will be taken because the presence of one or more clinical signs of acute circulatory failure: * systolic blood pressure \<90 mmHg (or a decrease \>50 mmHg in previously hypertensive patients) * the need of vasopressor drugs * oliguria (urine output \<0.5 ml/kg/min for at least 2 h) * tachycardia * delayed capillary refilling * the presence of skin mottling
Exclusion criteria
* Contraindication for the volume administration: evidence of fluid overload and/or of hydrostatic pulmonary edema * Patients with instable cardiac rhythm
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Predictive value of respiratory variation in brachial artery peak velocity before volume expansion assessed by ROC curve. We defined responser as patients that increased stroke volume index equal or more than 15% after fluid administration. | immediately after volume expansion |
Secondary
| Measure | Time frame |
|---|---|
| Evaluate the predictive value of pulse pressure variation for predicting hemodynamic response to fluid administration, comparing with the predictive value of respiratory variation of brachial artery peak velocity. | immediately after fluid administration |
| Evaluate the predictive value of stroke volume variation for predicting hemodynamic response to fluid administration, comparing with the predictive value of respiratory variation of brachial artery peak velocity. | immediately after volume expansion |
Countries
Spain
Outcome results
None listed