Critical Illness, Fluid Responsiveness
Conditions
Keywords
Passive Leg Raise, Fluid Challenge, Common carotid artery
Brief summary
Passive leg raise (PLR) and fluid challenge are useful tools in assessing the fluid responsiveness. However, they require continuous monitoring of cardiac output, which is usually an invasive technique and in some cases not always available. Vascular ultrasound can be an alternative to cardiac output monitoring in a fluid status evaluation. The common carotid artery (CCA) is an easily accessible vessel. It has recently been noted that the diameter of this artery changes after an intravenous fluid bolus. It is possible that the change in the diameter of the common carotid artery during passive leg raise and fluid challenge can be a predictor of fluid responsiveness.
Interventions
DIAGNOSTIC_TESTfluid responsiveness assessment
During the procedure, the investigator will be imaging one of the carotid arteries with ultrasound. In expiratory phase, four sets of three video loops will be recorded: before and after PLR and then before and after fluid challenge. There also will be noted hemodynamic parameters measured with PiCCO monitor. The fluid challenge is defined as administration of 500ml of crystalloid in less than 10 minutes. Later, another investigator, who will be blinded to other data, will measure the maximal and minimal diameter of CCA in each loop. The measurements will be averaged and eventually two values (maximal an minimal) from each set will be obtained.
Sponsors
Uniwersytecki Szpital Kliniczny w Opolu
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* mechanically ventilated patients with circulatory failure, who are monitored with PiCCO and need fluid responsiveness assessment
Exclusion criteria
* contraindication for the volume administration (hydrostatic pulmonary edema or other evidence of fluid overload) * contraindication for PLR test (e.g. after trauma) * lack of possibility to examine the carotid arteries * bilateral carotid surgery in the past * bilateral anatomical defects of the carotid arteries * unstable cardiac rhythm (e.g. atrial fibrillation)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the diameter of the common carotid artery | 1 minute after PLR test and 1 minute after fluid challenge | The diameter will be measured with ultrasound |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation the value of changes in the diameter of CCA as the predictor of fluid responsiveness. | 1 minute after PLR test and 1 minute after fluid challenge | The changes in the diameter of CCA will be compared with the changes in cardiac output measured with PiCCO method. |
Countries
Poland
Outcome results
None listed