Circulatory Failure, Shock
Conditions
Keywords
mini fluid challenge, subaortic velocity time integral
Brief summary
The main objective of this study is to show that the variation of the subaortic velocity time integral after a mini test by filling 100 cc of normal saline over 1 minute (ΔITV100) is predictive of response to filling (defined as an increase in aortic velocity time integral measured by transthoracic ultrasound over 15% after administration of 500 cc of normal saline over 15 minutes) in non-ventilated shock patients.
Detailed description
The secondary objectives of this study include: * To determine the sensitivity and specificity of the variation of the velocity time integral after administration of 100 cc of normal saline over 1 minute (ΔITV100) to predict the response to the filling. * To study the inter-observer variation of ΔITV100 measurement. * To compare ΔITV100 to other clinical and radiological parameters for predicting response to filling (initial value of the subaortic velocity time integral, variation in mitral E wave, E / A, respiratory variation of the diameter of the inferior vena cava, marbling clinical evolution score.
Interventions
None listed
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The patient must have given his/her informed and signed consent * The patient must be insured or beneficiary of a health insurance plan * Systolic blood pressure (SBP) \< 90 mmHg * Signs of inadequate cardiac output: urine output \<0.5 ml / kg / h for more than two hours, hyperlactataemia * Requires amines to maintain an SBP ≥ 90 mmHg or inability to lower amines or requires an increase in amines
Exclusion criteria
* The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * The patient (or his/her person-of-trust) refuses to sign the consent * It is impossible to correctly inform the patient * The patient is pregnant, parturient, or breastfeeding * The patients has a contraindication for a treatment necessary for this study * Cardiogenic shock * Acute pulmonary edema * Moribund patient * Non echogenic patient * Patient with cardiac arrhythmia * Patients for whom the passive leg raising test is contraindicated (hyper intra-abdominal pressure, pelvic or lower limb trauma)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in the subaortic velocity time integral after 100cc of normal saline over 15 minutes (cm^2) | baseline; 26 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in heart rate after the mini-fluid challenge | baseline; 26 minutes | (bpm,%) |
| Change in mean arterial pressure after the mini-fluid challenge (mmHg) | baseline; 26 minutes | — |
| Change in mitral E wave (cm / s) after the mini-fluid challenge | baseline; 26 minutes | — |
| Change if the subaortic velocity time integral after a passive leg raising trial (cm^2) | baseline; 15 minutes | — |
| Change in the Marbrure clinical score after the mini-fluid challenge | baseline; 26 minutes | — |
| Change in lower vena cava diameter | baseline; 8 minutes | (DiameterMax-DiameterMin) / DiameterMax (cm;%) |
| Change in the E/A ratio after the mini-fluid challenge | baseline; 26 minutes | — |
Countries
France
Outcome results
None listed