The study investigates if a brief breath volume change in a ventilator-induced patient can indicate fluid therapy response by detecting pulse pressure changes in severe breathing patients receiving breaths through machines and in a prone position.
- Conditions
- Health Condition 1: J960- Acute respiratory failureHealth Condition 2: 4- Measurement and Monitoring
- Registration Number
- CTRI/2024/02/063146
- Lead Sponsor
- Tata Memorial Hospital, Mumbai
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Open to Recruitment
- Sex
- Not specified
- Target Recruitment
- 0
1 Adult patients Age more than 18 years
2 Suffering From Acute Respiratory Distress Syndrome ARDS defined as per Berlins Criteria.
3 Undergoing mechanical ventilation via lung protective low tidal volume strategy using Volume assist control ventilation without any spontaneous breathing activity (deeply sedated/ paralyzed as seen on pressure time curve on ventilator), in prone position.
4 Having invasive continuous cardiac output monitoring using PICCO device (Pulsion Medical Systems, Feldkirchen, Germany) with Phillips Intel View monitor MP700
5 Patients of acute circulatory failure defined as the presence of systolic blood pressure (SBP) less than or equal to 90 mm Hg or mean arterial pressure (MAP) less than or equal to 70 mm Hg or requiring vasopressors to maintain SBP more than 90 or MAP more than 70 along with one or more of the following: a) urine flow less than 0.5 mL per kg per hr for more than 2hours. b) heart rate more than 100 beats per minute. c) Presence of skin mottling d) blood lactate concentration more 2 mmol per L in whom the treating physician plans to give a fluid bolus
1 Age less than 18 years.
2 Patients with cardiac arrythmia, known valvular heart disease, intracardiac shunt, right ventricular dysfunction, air leakage through chest drains, abdominal compartment syndrome.
3 Pregnant Females
4 Patient refusing consent to participate in the study
5 Extravascular Lung water Index (EVLWI) >12 (except in those patients in whom treating clinician wishes to give a fluid bolus to the patient)
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To assess whether change in PPV while transiently increasing tidal volume to 8ml per kg Predicted Body Weight in patients suffering from ARDS undergoing low tidal volume ventilation in prone position adequately predicts fluid responsiveness.Timepoint: 30 min after starting the intervention
- Secondary Outcome Measures
Name Time Method To study the effect of lung compliance on the validity of tidal volume challenge test to predict fluid responsiveness in patients suffering from ARDS undergoing low tidal volume ventilation in prone ventilation.Timepoint: 1 months after starting the trial enrollment