Mean Systemic Filling Pressure and Heart Performance Predicting Fluid Responsiveness in Sepsis

Launched by CATHARINA ZIEKENHUIS EINDHOVEN · May 19, 2016

Keywords

ClinConnect Summary

The assessment of the cardiovascular state in critically ill patients is subject to difficulties in terms of the fact that several hemodynamic parameters, for example mean arterial blood pressure (MAP) and cardiac output (CO) supply insufficient information about the circulating volume and cardiac performance. There is a clinical need to adequate determination of intravascular volume status and therefore reliable predictors of fluid responsiveness are highly relevant. However, in determining the fluid status of a patient, the lack of appreciation of the venous side of the circulation persis...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients must be older than 18 years, and must be equipped with a pulse-contour cardiac output system with a central venous catheter.
• • Patients will be subsequently connected to the hemodynamic monitoring device Navigator™.
• • In those patients with clinical signs of inadequate tissue perfusion, passive leg raising and standardized fluid challenge will be performed.
• Exclusion Criteria:
• • Patients with assist devices (e.g. intra aortic balloon pump, Impella®, ECMO), patients with arrhythmias (either atrial of ventricular) will be excluded from the study.
• • Also, patients with inguinal impairment or contraindications for a passive leg raising will be excluded (such as deep venous thrombosis or elastic compression stocking), head trauma, an increase intra-abdominal pressure suspected by clinical context and examination as well as patients with absolute contraindications for fluid challenge.