Fluid Responsiveness, Haemodynamics, Pulse Pressure Variation
Conditions
Keywords
haemodynamics;, Pulse pressure variation;, fluid responsiveness;, Mechanical ventilation;
Brief summary
The investigators studied the predictive value of PPV in the patients with different influencing factors;and the method to improve the predictive value,which can improve the application of PPV in ICU.
Detailed description
PPV can be used to predict fluid responsiveness in patients with circulatory shock.However, it is affected by many factors, which leads to the decrease of the applicability of PPV in ICU.Therefore, the investigators studied the predictive value of PPV in the patients with different influencing factors;and the method to improve the predictive value,which can improve the application of PPV in ICU.
Interventions
DEVICEPatients were ventilated with assist-control ventilation（A/C） mode at different tidal volume
Ventilation mode was set to assist-control volume ventilation with different tidal volume, respiratory frequency 15 times/min, PEEP 5 centimeter water column.
BEHAVIORALspontaneous breathing and no spontaneous breathing
Data were recorded when patients had and did not have spontaneous breathing
Sponsors
Southeast University, China
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients requiring invasive mechanical ventilation * Acute circulatory failure,defined as:systolic blood pressure \<90 mmHg or blood pressure in patients with previous hypertension lower than the baseline value\> 40 mmHg; vasoactive drugs are required to maintain blood pressure (mean arterial pressure\> 65 mmHg); with or without signs of hypoperfusion (oliguria\<0.5ml.kg-1.h-1 for at least 2 hours; arterial blood lactic acid\>2.5mmol.L-1; skin mottling)
Exclusion criteria
* The age of the patient is less than 18 years old or more than 80 years old * Refuse to sign the informed consent to join the group * Atrial fibrillation and other arrhythmias that seriously affect the output per beat; * With pregnancy * Other situations where the clinician believes that the patient is not suitable for inclusion in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cardiac output(CO) | 1 day | The measurement of cardiac output(CO); |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| measurement of Pulse pressure variation（PPV）from monitor; | Research period | Pulse pressure variation (PPV)(percent) ,whic is calculated from the systolic and diastolic blood pressure,can be read from the monitor directly. |
| measurement of airway pressure variables from ventilator | 1 day | The investigators record the airway pressure variables during the inspiration and expiration from the ventilator |
| P 0.1 | 1 day | airway occlusion pressure at 100 milliseconds after the onset of inspiration (P0.1)(cmH2O) |
| Pocc | 1 day | delta change of airway pressure during expiratory occlusion in different interventions. |
| measurement of Hemodynamic variables from the monitor; | 1 day | The investigators record the hemodynamic variables from the monitor MAP and CVP |
Other
| Measure | Time frame | Description |
|---|---|---|
| Outcome | 28 day | ICU， 28day and hospital mortality |
| transpulmonary pressure | 1 day | transpulmonary pressure and delta transpulmonary pressure |
| Pes | 1 day | esophageal pressure |
Countries
China
Outcome results
None listed