Discontinuous Echocardiographic Subcostal Cardiac Output Measurement by the Right Ventricular Outflow Tract in Critical Care
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Measurement of Cardiac Output (CO) via the subcostal route
研究概览
简要总结
Cardiac output (CO) monitoring is recommended for the most serious and multiple-failure patients in critical care and allows the diagnosis of acute circulatory failure as well as its etiology and also allows the monitoring of treatments. However, although allowing an adaptation of hemodynamic treatments and being integrated into a therapeutic personalization approach in situations of acute circulatory failure, the measurement of CO is conditioned by the availability of devices, by their sometimes problematic invasiveness, as well as their cost. In addition, the discontinuous measurement of CO by echocardiography is made difficult in the context of resuscitation with patients who are less mobilizable and less echogenic.
详细描述
The subcostal assessment route is the classic emergency route. It allows for the analysis of the basic segmental kinetics of the left ventricle, an analysis of the Left Ventricular Ejection Fraction (LVEF), the search for pericardial effusion or even tamponade, or the search for right ventricular dilation. A measurement of CO via the right ventricular outflow tract using transthoracic echocardiography has never been described in the literature, although it is feasible, based on the same mathematical rationale as the standard measurement of cardiac output via the left ventricular outflow tract (which takes into account the diameter of the outflow tract and the subvalvular time-velocity integral [TVI]).
Since at all times the left (systemic) CO is equal to the right (venous return) CO, it is therefore possible to consider a measurement of CO via the subcostal route. By not complicating the standard care of patients in critical care, especially in situations of acute circulatory failure, and by adding only a few seconds or even minutes to an examination already recommended and routine in critical care, this evaluation approach seems interesting given the need and the recommendations in force on the monitoring of patients in intensive care and more particularly of DC.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Prospective
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 patient (Age ≥ 18 years)
- •Patient admitted to the intensive care unit at Rouen University Hospital.
- •Transthoracic echocardiography (TTE) is required upon admission or during the patient's stay for diagnostic assessment and/or therapeutic monitoring.
排除标准
- •Person deprived of liberty by an administrative or judicial decision or person placed under judicial protection/guardianship or curatorship
- •Patient not affiliated with the social security system
- •Refusal by the patient or trusted person if the patient is incapable of expressing consent
- •Pregnant woman
- •Dying patient
结局指标
主要结局
Measurement of Cardiac Output (CO) via the subcostal route
时间窗: At Enrollment visit and DAY 28
To assess the concordance of the measurement of cardiac output in the ejection chamber of the right ventricle (DC-CEVD, innovative method) with that of cardiac output in the ejection chamber of the left ventricle (DC-CEVG, reference method) on subcostal transthoracic ultrasound (TTE).
次要结局
- Compare the measurement success rate of DC-CEVD to that of DC-CEVG.(At Enrollment visit and DAY 28)
- To assess the concordance of DC variation during preload-dependence search maneuvers (passive leg raise) in intubated and ventilated patients between DC-CEVD and DC-CEVG measurements.(At Enrollment visit and DAY 28)
- DC measurement by transpulmonary thermodilution device(At Enrollment visit and DAY 28)