Efficacy of Caval Aorta Index for Fluid Optimization in Critically Ill Patients With Traumatic Brain Injury
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Mansoura University
- Enrollment
- 92
- Primary Endpoint
- fluid balance
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, 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.
Eligibility Criteria
- Ages
- 18 Years to 60 Years (Adult)
- Sex
- All
- Accepts 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
Arms & Interventions
Control group
Intervention: control group (Other)
ultrasound-guided caval-aorta index group
Intervention: ultrasound measurement of caval aorta index (Procedure)
Outcomes
Primary Outcomes
fluid balance
Time Frame: after 96 hours from the admission
the difference between fluid input and fluid loss
Secondary Outcomes
- Central capillary refill(Daily for 7 days)
- Central Venous Pressure (CVP) measurements(Daily every 6 hours for 7 days)
- Frequency and duration of hypotension(within first 7 days)
- Glasgow Coma Scale(daily within first 7 days)
- incidence of pulmonary edema(Daily within first 7 days)
- Urine output(Daily for 7 weeks)
Investigators
maha abou-zeid
Assistant Professor of Anesthesia and Surgical Intensive Care
Mansoura University