Fluid Balance
Conditions
Keywords
caval aorta index, traumatic brain injury
Brief summary
Traumatic brain injury is a leading cause of death and disability in trauma patients. As the primary injury cannot be reversed; management strategies must focus on preventing secondary injury by avoiding hypotension and hypoxia besides, maintaining appropriate cerebral perfusion pressure, which is a surrogate for cerebral blood flow.
Detailed description
The caval aorta index is an ultrasound element, relatively new, used to assess volume status. Technically, the sonographic assessment of the inferior vena cava /aorta diameter ratio is an easy test to perform and can be performed effectively by doctors who are not experienced in the field of sonography (Kusumastuti et al .2021). In this study; the caval aorta index will be used to guide fluid dosage in critically ill patients with traumatic brain injury.
Interventions
PROCEDUREultrasound measurement of caval aorta index
ultrasound measurement of caval aorta index
OTHERcontrol group
fixed fluid prescription
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Masking description
A vascular US expert will read the number contained in computer generated randomization software and determine group assignments. Daily; he will be responsible on prescribing of the required fluid.
Intervention model description
After enrollment, patients will be randomly allocated using block into two groups of 46 patients in each group; ultrasound-guided fluid management (US group) or standard care (C group)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Traumatic brain injury diagnosed by computed tomography scan Glasgow coma score ≥ 4
Exclusion criteria
Inability to get consent. Pregnant and lactating women Traumatic subarachnoid hemorrhage Spinal cord injury Increased intra-abdominal pressure Abdominal aortic aneurysm Inferior vena cava (IVC) thrombus Portal hypertension Acute corpulmonale Congestive heart failure chronic hemodialysis Surgical intervention other than neurological one within the first 7 days Mechanical ventilation need during first 7 days Cardiac arrest during the first 7 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| fluid balance | after 96 hours from the admission | the difference between fluid input and fluid loss |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Central Venous Pressure (CVP) measurements | Daily every 6 hours for 7 days | cm H2O |
| Frequency and duration of hypotension | within first 7 days | systolic blood pressure less than 90 mmhg |
| Urine output | Daily for 7 weeks | mL |
| Central capillary refill | Daily for 7 days | seconds |
| incidence of pulmonary edema | Daily within first 7 days | new B-lines in lung Ultrasound |
| Glasgow Coma Scale | daily within first 7 days | range from 3-to-15 |
Contacts
Primary ContactMaha Ahmed Abozeid, Assistant Professor
Outcome results
None listed