Hemodynamic Variations During Remote Ischemic Conditioning in Critical Ill Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Critical Illness
- Sponsor
- Lithuanian University of Health Sciences
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Maximal change in stroke volume index during remote ischemic conditioning (RIC) procedure
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The main objectives of this study are to evaluate the changes in hemodynamics occurring during the remote ischemic conditioning (RIC) procedure and to compare the hemodynamic responses elicited by passive leg raising before and after the RIC intervention.
Detailed Description
The investigators hypothesized that the inflation of the blood pressure cuff during the remote ischemic conditioning (RIC) procedure would lead to an increase in stroke volume (SV), cardiac index (CI), and peripheral perfusion index and that these changes would correlate with the hemodynamic changes induced by passive leg raising (PLR). Furthermore, the clinical relevance of the RIC effect in critically ill patients, particularly in terms of determining their hemodynamic responsiveness, remains uncertain. The investigators hypothesized that the RIC procedure influences hemodynamic changes during PLR.
Investigators
Andrius Pranskunas
prof.
Lithuanian University of Health Sciences
Eligibility Criteria
Inclusion Criteria
- •aged over 18 years,
- •admitted to the intensive care unit,
- •monitored with a transpulmonary thermodilution device with calibrated pulse contour analysis (Pulsion Medical Systems, Munich, Germany),
- •decision by the physician in charge to perform passive leg raising.
Exclusion Criteria
- •pregnancy,
- •advanced malignancy,
- •peripheral artery disease affecting both arms,
- •head trauma,
- •deep vein thrombosis in the lower limbs,
- •intra-abdominal hypertension, defined as an intra-abdominal pressure greater than 12 mmHg.
Outcomes
Primary Outcomes
Maximal change in stroke volume index during remote ischemic conditioning (RIC) procedure
Time Frame: During RIC procedure
Change in this parameter is determined during each inflation and release of the blood pressure cuff.
Maximal change in cardiac index during RIC procedure
Time Frame: During RIC procedure
Change in this parameter is determined during each inflation and release of the blood pressure cuff.
Maximal change in peripheral perfusion index during RIC procedure
Time Frame: During RIC procedure
Change in this parameter is determined during each inflation and release of the blood pressure cuff. The perfusion index is measured on a hand that is not equipped with a blood pressure cuff.
The correlation between the maximal changes in stroke volume index, cardiac index, and peripheral perfusion index observed during the RIC procedure and those observed during passive leg raising (PLR).
Time Frame: During RIC procedure, as well as during passive leg raising.
The maximum changes in these parameters, as determined by the RIC procedure and PLR, were identified, and their correlation was subsequently calculated. The perfusion index is measured on a hand that is not equipped with a blood pressure cuff.
The correlation between the maximal changes in stroke volume index, cardiac index, and peripheral perfusion index observed during PLR before the RIC procedure and those observed during PLR after the RIC procedure.
Time Frame: During PLR both before and after the RIC procedure.
The maximum changes in these parameters, as measured during PLR before and after the RIC procedure, were identified. Subsequently, the correlation between these changes was calculated. The perfusion index is measured on a hand that is not equipped with a blood pressure cuff.
Secondary Outcomes
- The correlation between the maximum perfusion index (PI), the time to reach maximum PI during cuff release and the maximal changes in stroke volume index, cardiac index and perfusion index observed during PLR.(During RIC procedure, as well as during PLR.)