Diagnostic Accuracy of the Inferior Vena Cava Collapsibility to Predict Fluid Responsiveness in Spontaneously Breathing Patients With Sepsis, Acute Circulatory Failure, and Irregular Cardiac Rhythm
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 55
- 试验地点
- 1
- 主要终点
- respiratory variations in inferior vena cava diameters with respect to the response to fluid resuscitation, assessed by the area under the ROC curve
研究概览
简要总结
Objectives: To investigate whether respiratory variations of inferior vena cava diameters (cIVC) predict fluid responsiveness in spontaneously breathing patients with septic acute circulatory failure and irregular heartbeats.
Design: Prospective, bicentric study, intensive care units.
Patients and measures: Spontaneously breathing patients with sepsis and clinical signs of acute circulatory failure are included. A positive response to fluid loading (FL) is defined as an increase of the stroke volume (SV) >10%. The investigators measured the minimum inspiratory and maximum expiratory diameters of the IVC (idIVC and edIVC) during standardized (st) and unstandardized (ns) breathing. The investigators calculated cIVCst and cIVCns before a 500ml-colloid FL.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients of the intensive care units of the Lille university-hospital and of the Valencienne general hospital.
- •Age greater than or equal to
- •Patient insured
- •Spontaneous breathing without ventilatory support or intubation or tracheotomy.
- •Irregular cardiac rhythm
- •Prescription by the physician in charge of the patients of a 500 mL volume expansion in less than 30 minutes.
- •Patients with sepsis with at least one sign of acute circulatory failure:
- •Tachycardia with heart rate> 100/min
- •systolic blood pressure <90mmHg or a decrease >40mmHg in previously hypertense patient
- •Oliguria <0.5ml/kg/hour for at least one hour
- •skin mottling
排除标准
- •high-grade aortic insufficiency
- •transthoracic echogenicity unsuitable for measuring the stroke volume or inferior vena cava diameters
- •clinical signs of active exhalation
- •clinical or ultrasonographic evidence of pulmonary edema due to heart failure
- •pregnancy
- •abdominal compartment syndrome
- •regular cardiac rhythm
结局指标
主要结局
respiratory variations in inferior vena cava diameters with respect to the response to fluid resuscitation, assessed by the area under the ROC curve
时间窗: during 30 minutes of the volume expansion
次要结局
未报告次要终点