Correlation of serial femoral venous Doppler versus VExUS score to predict organ dysfunction and outcomes in patients with cardiac failure.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 107
- 试验地点
- 1
- 主要终点
- To compare serial FVD and serial VExUS scoring as a predictor of organ dysfunction in acute heart failure patients.
研究概览
简要总结
Femoral venous Doppler (FVD) assessment for venous congestion (VC) is a newer tool and it is technically easier to acquire images of the vein compared to venous excess ultrasound grading (VExUS). Also, since the common femoral vein is directly connected to the inferior vena cava (IVC), facilitating the transmission of pressure waves as the VC increases due to heart failure (HF). Patterns in FVD describing the degree of congestion have been studied and documented. Also, few studies have used FVD to develop diagnostic algorithms. Recently, FVD has also been proposed as a tool to diagnose right ventricular dysfunction in patients undergoing cardiac surgery.
FVD has an advantage that it is simpler to measure than the VExUS and also quantify the degree of VC. With this background, FVD appears to be having a potential in predicting the degree of organ dysfunction due to VC. This could in turn lead to HF regimens being optimized to normalization of FVD patterns for better outcome in patients. Till date, there have been no prospective studies evaluating the utility of FVD to assess VC in patients with acute heart failure.
The aim of this study is to see whether serial FVD scans to assess the degree of VC have a correlation with organ dysfunction in patients admitted to intensive care unit with acute heart failure.
We propose to conduct a prospective observational study to assess the utility of serial FVD and VEXuS score in predicting the morbidity of patients with acute heart failure admitted to intensive care unit.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •Getting admited with a diagnosis of acute heart failure [defined as recent worsening of shortness of breath or oxygen saturation (SpO2) < 90% on room air or orthopnea/paroxysmal nocturnal dypnea (PND) along with an increase in NT proBNP].
排除标准
- •1.Need for intubation (or already intubated).
- •2.Signs or symptoms or markers of hypoperfusion: cold extremities, altered mentation, confusion, oliguria, Lactate > 2 mmol/L.
- •3.Persistent hypotension (SBP < 90 mmHg).
- •4.Requirement of two or more vasoactive agents to maintain blood pressure.
- •5.Requirement for invasive cardiac output monitoring.
- •6.Requirement for Mechanical Circulatory Support.
- •7.Heart rate < 40 b.pm or persistent life-threatening arrhythmia.
- •8.Any associated non-cardiac condition requiring critical care admission.
- •9.Pulmonary arterial systolic pressure > 55mm/hg by bedside 2d-echocardiography 10.Patients with comfort care directives.
- •11.Suspected sepsis 12.Pregnancy 13.Liver cirrhosis 14.Severe ascites (Grade 3 Ascites defined as Large or gross ascites with marked abdominal distension).
结局指标
主要结局
To compare serial FVD and serial VExUS scoring as a predictor of organ dysfunction in acute heart failure patients.
时间窗: Until admitted in ICU
次要结局
- To determine the correlation between femoral venous Doppler and right ventricular function.(Until admitted in ICU)
- To compare the degree of venous congestion assessed by serial femoral venous Doppler in acute heart failure patients with organ dysfunction.(Until admitted in ICU)
- To determine the utility of femoral venous Doppler as a prognostic marker in acute heart failure patients.(Until admitted in ICU)