Fluid Resuscitation Monitoring Non-invasively
Conditions
Brief summary
Recently, bedside ultrasound has become an important tool for the simple and non-invasive hemodynamic assessment of critically ill patients. This applies not only to echocardiography but also to ultrasound of large extra-thoracic veins. The sonography can provide real time assessment of the vascular system and hemodynamic status at the bedside. To our knowledge, there is one report about the association between sonographically assessed carotid artery diameter and intravascular volume, which raised recommendation for further studies including the interplay between carotid geometry and intravascular fluid status. Aim of the study: The aim of this work is to evaluate the accuracy of noninvasive techniques for assessment of intravascular volume status by Sonographic assessment of both the common carotid artery diameter (CCA) and the central venous pressure (CVP) in response to a bolus of crystalloid solution infusion and to find the correlation between CCA diameter and CVP as the primary outcome in adults patients after major surgeries who needs close assessment and maintenance of the intravascular volume status.
Interventions
DIAGNOSTIC_TESTcommon carotid artery diameter measurement
measurement of common carotid artery diameter will be carried out two times: the initial measurement (pre-infusion) which is followed by infusion of crystalloid solution (Ringer lactate) 30 ml/min till reaching a total infusion volume of 7 ml/kg body weight then another ultrasound measurement will be taken (prost-infusion). Between these sequential measurements, the patient position will not be changed. The percentage increase in CCA diameter will be calculated using the formula: \[(dia-mpost/dia-mpre) × 100\] - 100 \[11\].
Sponsors
Beni-Suef University
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Male and female patients (age 20-60 years). 2. ASA physical status I and II 3. Patients who are able to breathe spontaneously and lie supine. 4. Patients who have CVP catheter (subclavian or internal jugular vein).
Exclusion criteria
1. History of carotid artery surgery 2. Significant cardiac disease (cardiomyopathy and/or moderate to severe valvular heart lesion). 3. Significant hepatic disease (Child-Pugh score B or C ). 4. Renal failure. 5. Obesity: BMI ˃ 30 kg/m2 6. Need for mechanical ventilation. 7. Pregnancy. 8. Unstable vital signs during the process of sonography (e.g. the patients on vasoactive drugs)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Common Carotid Artery diameter at expiration (millimetre) | 30 minutes before fluid bolus infusion | common carotid artery internal diameter changes songraphically measured to assess intravenous resuscitation |
| Central venous pressure (centimetre water) | 5 minutes after fluid bolus infusion | Central venous pressure changes measured to assess intravenous resuscitation |
Countries
Egypt
Contacts
Primary ContactSamaa A. Kasem, MD
Outcome results
None listed