Liver Cirrhoses
Conditions
Brief summary
The investigators hypothesize that trans-thoracic ultrasound performed by non-specialist gastroenterologists with a standard training by intensive care doctors will give equivalent results to those achieved by experts for a simple evaluation of hemodynamic status.
Interventions
OTHERTrans-thoracic ultrasound
Trans-thoracic ultrasound performed by an expert and a non-expert
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient must be an adult at least 18 years old * Patient has known or suspected cirrhosis (diagnosed by biopsy or based on recognized clinical/biological/radiological criteria) * Admitted to the gastroenterology service for odematous-ascitic decompensation defined by edema of the lower limbs, and/or ascites, anasarca, associated or not with weight gain.
Exclusion criteria
* The subject is participating in an interventional study, or is in a period of exclusion determined by a previous study * The subject refuses to sign the consent * It is impossible to give the subject informed information * The patient is under safeguard of justice or state guardianship * Patient is pregnant or breastfeeding * Patient already participated in the study * Patient with cirrhosis admitted for a different decompensation (active digestive hemorrhage or sepsis) * Poorly echogenic patient * Patient withdraws consent * Patient with anasarca of cardiac origin * Ultrasound diagnosis of a severe cardiac pathology requiring specialized treatment in intensive care or cardiology (severe cardiac insufficiency, acute pulmonary edema, endocarditis, severe valvulopathy, cardiac tamponade, intracardiac thrombus)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Concordance in Left Ventricular Ejection Fraction measurement on trans-thoracic ultrasound by expert versus a non-specialist gastroenterologist with standard training | 48 hours | Difference in measured Left Ventricular Ejection Fraction (%) |
| Concordance in E' wave at the lateral mitral ring and mitral E wave measurement by expert versus a non-specialist gastroenterologist with standard training | 48 hours | Difference in measured E / E' ratio |
| Concordance in stroke volume measurement by expert versus a non-specialist gastroenterologist with standard training | 48 hours | Difference in measured velocity-time integral (cm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Death rate | Day 28 | — |
| Duration of hospitalization | End of follow-up (maximum 28 days) | — |
| Number of admissions to intensive care | End of follow-up (maximum 28 days) | — |
| Consummation of diuretics | Day 0 | — |
| albumin infusion necessity | Day 0 | — |
| Use of vasopressors | Day 0 | — |
| auto ejection fraction measurement on trans-thoracic ultrasound by expert | Day 0 | Doppler |
| lateral mitral annulus measurement on trans-thoracic ultrasound by expert | Day 0 | Doppler |
| Mitral E wave measurement on trans-thoracic ultrasound by expert | Day 0 | Doppler |
| Mitral A wave measurement on trans-thoracic ultrasound by expert | Day 0 | Doppler |
| Inferior vena cava collapsibility index measurement on trans-thoracic ultrasound by expert | Day 0 | Doppler |
| Presence of intrapulmonary shunt | Day 0 | Y/N |
| Presence of aortic stenosis | Day 0 | Y/N |
| Presence of mitral insufficiency | Day 0 | Y/N |
| Presence of mitral stenosis | Day 0 | Y/N |
| left atrium surface area | Day 0 | cm2 |
| left ventricle diameter | Day 0 | mm |
| Septal wall thickness | Day 0 | mm |
| Posterior wall thickness | Day 0 | mm |
| tricuspid annular plane systolic excursion | Day 0 | mm |
| tricuspid annular plane systolic velocity | Day 0 | cm/s |
| heart chamber dilation | Day 0 | — |
| pulmonary arterial hypertension | Day 0 | mmHg |
| Pericardial effusion | Day 0 | — |
Countries
France
Outcome results
None listed