Shock
Conditions
Keywords
VExUS, Fluid Resuscitation, Fluid Responsiveness, Fluid Overload, Shock
Brief summary
This study aims to explore the feasibility and scientific validity of carotid-jugular Doppler in evaluating volume tolerance in shock patients (with the VExUS score as an important reference standard), and to conduct an in-depth analysis of the correlation between its monitoring indicators and patient prognosis.The primary endpoint is comparison of the agreement between hands-free carotid-jugular Doppler and the VExUS score in evaluating volume tolerance.The secondary endpoint is correlation between volume tolerance assessed by hands-free carotid-jugular Doppler and the clinical outcomes of shock patients.
Interventions
None listed
Sponsors
Southeast University, China
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Shock patients admitted to the ICU are defined as those with persistent hypotension (systolic blood pressure \< 90 mmHg or a decrease of ≥ 40 mmHg from the baseline blood pressure) accompanied by signs of tissue hypoperfusion. * Age ≥ 18 years old. * The patient or their legal representatives signed the informed consent form.
Exclusion criteria
* Patients with severe pulmonary circulatory disorders such as severe pulmonary hypertension and acute pulmonary embolism. * Patients with right ventricular myocardial infarction or severe tricuspid regurgitation. * Patients with severe neck trauma or deformity that affects Doppler examination of cervical arteries and veins, or those with anatomical contraindications preventing evaluation of at least one cervical artery or vein. * Pregnant or lactating women. * Patients with diseases that may interfere with abdominal ultrasound examination.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hands-free Carotid Artery and Vein Doppler Parameters | Time of shock in ICU within 3 days | Elevate the patient's upper body to 45°, keep the legs flat, place the long axis of the probe perpendicular to the carotid vessels (with the probe height not exceeding the upper edge of the thyroid cartilage), locate the optimal signals of the common carotid artery and internal jugular vein waveforms, and then fix the probe. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PiCCO | Time of shock in ICU within 3 days | Inject cold saline through central venous catheterization, sense temperature changes via arterial catheter, and obtain hemodynamic parameters such as cardiac output by combining thermodilution and pulse contour analysis. |
| Venous Excess Ultrasound Score | Time of shock in ICU within 3 days | Evaluate the diameter, waveform, etc. of the inferior vena cava, hepatic veins, portal vein, and intrarenal veins sequentially via ultrasound, and comprehensively derive a grade ranging from 0 to 3.Grade 0: No congestion; Grade 1: Mild congestion; Grade 2: Moderate congestion; Grade 3: Severe congestion. |
| Bioelectrical Impedance Analysis | Time of shock in ICU within 3 days | Attach electrodes to the patient's limbs, input basic information, measure impedance of multiple parts with multi-frequency technology, and quickly obtain parameters such as body composition. |
| Duration of shock | Time of shock in ICU within 28 days | Time of shock in ICU within 28 days |
| Duration of Mechanical Ventilation | up to 24 weeks | Duration of Mechanical Ventilation During ICU Admission |
| Total Length of Hospital Stay | up to 24 weeks | Total Length of Hospital Stay |
| Length of ICU stay | up to 24 weeks | Length of ICU stay |
| mortality of 28 days | Incidence of death during 28 days | Incidence of death during 28 days |
| In-hospital Mortality | up to 24 weeks | In-hospital Mortality |
| Vasoactive Agent Dosage | up to 24 weeks | Vasoactive Agent Dosage During ICU Admission |
| Time without vasoactive agents within 28 days | Time without vasoactive agents within 28 days | Time without vasoactive agents within 28 days |
Countries
China
Outcome results
None listed