Arterial Pressure Derived Dynamic Parameters to Detect Preload Responsiveness in Spontaneously Breathing Patients

Launched by CHU DE REIMS · Jun 25, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a method to help doctors determine if critically ill patients who are breathing on their own will benefit from receiving extra fluids. When patients are in septic shock, they often need fluids, but giving too much can be harmful if their heart isn't pumping enough blood. The researchers will look at specific measurements from patients' blood pressure and how their heart responds when they lift their legs for a minute. By comparing these measurements, they hope to identify which patients will respond positively to fluid treatment.

To participate in this study, patients must be over 18 years old and hospitalized in intensive care with signs of low blood pressure or other issues that suggest they may need fluids. They also need to be able to breathe without assistance and have a special catheter in place to monitor their blood pressure. However, patients with certain conditions, like irregular heartbeats or those who cannot lift their legs, are not eligible. If chosen for the trial, participants can expect to undergo some simple tests while being closely monitored to help doctors make better decisions about their treatment.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient over 18 years old.
• • Hospitalized in intensive care.
• * For which the clinician in charge of the patient will need to predict the response to fluids and decide on a possible infusion of fluids, because of:
• • Acute circulatory failure with mean arterial pressure \< 65mmHg or \< 30mmHg of its baseline value for hypertensive patients.
• * And/or other signs of hemodynamic instability (tachycardia, mottling, oliguria, hyperlactatemia) :
• • In spontaneous ventilation and without ventilatory assistance.
• • Previously equipped with an arterial catheter.
• • Affiliated to a social security scheme.
• Exclusion Criteria:
• • Patient with arrythmia (PPV is not applicable).
• • Patient with intra-abdominal hypertension (PLR test is not valid).
• • Patient with a contraindication/impossibility to the PLR maneuver (lower limb amputation, respiratory intolerance).
• • Patient with poor echogenicity noted previously.
• • Patient protected by law.