Inferior Vena Cava Indexes in Positive Pressure Supports
- Conditions
- Positive-Pressure RespirationsRespiratory Failure
- Interventions
- Other: IVC diametres
- Registration Number
- NCT03452046
- Lead Sponsor
- Tepecik Training and Research Hospital
- Brief Summary
Collapsibility (CI-IVC), distensibility (dIVC) and delta (ΔIVC) indices, which are dynamic measures of inferior vena cava (IVC) diameter, are used to assess the intravascular volume status in critically ill patients. Positive pressure support (PS) has been shown to induce IVC diameter distention by increasing intrathoracic pressure, and high positive expiratory pressure (PEEP) decreases the CI-IVC percentage (4). During Triggered positive pressure support it is necessary to clarify which IVC index is valid for measuring the volume status.it is aimed to compare the IVC indexes (CI-IVC, DIVC, ΔIVC), positive rate of change with pressure, correlation with central venous pressure and accurate prediction of volume status in patients with different positive pressure support.
- Detailed Description
The IVC diameters at different pressure supports were measured by the same clinician after obtaining a clear image of where the US and IVC measurements were made and the probe stabilization was achieved. He performed the procedure of changing the pressure supports, a blind independent intensive care physician without working, and recorded the applied pressure supports respectively. The different pressure supports applied are as follows:
1. PS 10 mmHg-PEEP 5 mmHg,
2. PS 0 mmHg- PEEP 5 mmHg
3. PS 10 mmHg- PEEP 0 mmHg.
4. T-tube (PS 0 mmHg-PEEP 0 mmHg)
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- Age>18 years
- Current use of mechanical ventilation through an endotracheal tube.
- Profound Hypoxia defined as a fraction of inspired oxygen requirement >90% or a PEEP >10 mmHg
- Patient-ventilator desynchrony or active agitation
- Unstable O2 requirement
- Cardiovascular instability
- Current PEEP requirements of >10 mmHg
- Current oxygen saturation (SpO2) of <88%.
- High intra abdominal pressure
- Right cardiac failure
- Morbid obesity
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description PS 10 mmHg, PEEP 5 mmHg IVC diametres IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index t tube (PS 0 mmHg PEEP 0mmHg) IVC diametres IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index PS 10 mmHg PEEP 0 mmHg IVC diametres IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index PS 0 mmHg PEEP 5 mmHg IVC diametres IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index
- Primary Outcome Measures
Name Time Method Determine the effect of positive pressure on IVC collapsibility index 12 month Determine the effect on CI-IVC of an increase in positive end-expiratory pressure and pressure support
Determine the effect of positive pressure on IVC distensibility index 12 month Determine the effect on distensibility index of an increase in positive end-expiratory pressure and pressure support
Determine the effect of positive pressure on IVC delta index 12 month Determine the effect on delta index of an increase in positive end-expiratory pressure and pressure support
- Secondary Outcome Measures
Name Time Method Determine the effect of positive pressure on central venous pressure 12 month Determine the effect on central venous pressure of an increase in positive end-expiratory pressure and pressure support
Trial Locations
- Locations (1)
Tepecik Research and Training Hospital
🇹🇷Izmir, Konak, Turkey