Ultrasonographic Predictors of Intravenous Fluid Responsiveness in Septic Shock and Its Correlation to Central Venous Pressure
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Ultrasonographic predictors of intravenous fluid responsiveness in septic shock and its correlation to central venous pressure
研究概览
简要总结
Introduction Aim of the work Patients and methods Type of study Exclusion criteria Statistical analysis Research ethics Reference
详细描述
Septic shock is a serious infectious condition characterized by low blood pressure and multiple organ damage. One of the traditional recommendations is to administer intravenous fluids as the first step to improve blood pressure(1).
However, studies have shown that not every patient benefits from aggressive intravenous hydration (2).
Previous studies have shown that certain parameters may correlate with volume status and others may not to correlate with patient volume status.
Hemodynamic parameters, such as stroke volume variation (SVV) and pleth variability index (PVI) may better predict fluid responsiveness. However, assessments of these parameters require invasive procedures and special monitoring equipment, which limits their clinical application (4).
Echocardiography has been widely adopted to diagnose and monitor cardiac dysfunction leading to hemodynamic instability, and shock pathophysiology in general.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •adult patients age≥18-year-old; written consent will be obtained.
- •septic shocked patients show signs of acute circulatory failure at any time within the first 72 hours.
排除标准
- •Patients confirmed to have cardiogenic shock.
- •History of heart failure or patient known to have moderate to severe valvular heart disease, congenital heart disease.
- •The presence of carotid artery stenosis >50% , newly detected common carotid stenosis >50% during the study period.
- •Non-sinus rhythm.
- •Moderate to severe anemia.
- •Markedly increased intraabdominal pressure as abdominal compartment syndrome, pregnancy.
- •Medically diseased kidneys, ureteric obstruction peri-nephric collection.
结局指标
主要结局
Ultrasonographic predictors of intravenous fluid responsiveness in septic shock and its correlation to central venous pressure
时间窗: Baseline
To evaluate whether carotid FTc as determined by Doppler ultrasound could be a predictor of fluid responsiveness in spontaneously breathing and MV patients.
Evaluation the predictive ability of ΔVpeak for fluid responsiveness in spontaneously breathing patients.
时间窗: Baseline
To evaluate the predictive ability of ΔVpeak for fluid responsiveness in spontaneously breathing patients. and the ΔVpeak will be calculated as follows: (maximum peak velocity - minimum peak velocity)/\[(maximum peak velocity + minimum peak velocity)/2\] × 100
Detection changes of regional splanchnic hemodynamics by color Doppler resistive index, and its improvement after fluid administration.
时间窗: Baseline
To detect changes of regional splanchnic hemodynamics by color Doppler resistive index, and its improvement after fluid administration. Resistive index (RI): (peak systolic velocity - end-diastolic velocity) / peak systolic velocity. The normal range is 0.50-0.70.
次要结局
未报告次要终点
研究者
Tasneem Hassan Younes
Assistant lecturer
Assiut University