Reliability of Respiratory Variability of Maximal Aortic Blood Flow Velocity Obtained by Ultrasonography-doppler in Patients Followed Up with a Diagnosis of Shock in Intensive Care Unit for Evaluating Fluid Responsiveness in Patients

Launched by ANKARA UNIVERSITY · Feb 24, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new way to assess how well patients with shock in the Intensive Care Unit (ICU) respond to fluid treatment. Shock is a serious condition that can lead to death, and knowing whether a patient will benefit from additional fluids can make a big difference in their recovery. Currently, doctors use a method called transpulmonary thermodilution (TPTD) for this assessment, but it requires special equipment and trained staff. This study will compare TPTD measurements with a simpler, non-invasive technique using ultrasound to look at blood flow, called ΔVaortmax. The goal is to determine if this ultrasound method can effectively indicate which patients need more fluids without the risks associated with more invasive tests.

To participate in the study, patients must be over 18 years old, admitted to the ICU with a diagnosis of shock, and showing signs of worsening shock despite receiving standard treatments for at least six hours. They should also be expected to stay in the ICU for at least two days. If eligible, patients will undergo both TPTD and ultrasound evaluations, and their results will be compared. This research may lead to a new, safer way to monitor patients during critical care, using equipment that is already available in most ICUs and potentially reducing the need for more invasive procedures.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age over 18 years old
• • Being admitted to medical intensive care unit of Ankara University Faculty of Medicine
• • Having a diagnosis of shock
• • Deteriorating shock state after the initial 6 hour despite optimal treatment
• • Patients or their relatives are required to read, understand and sign the informed consent form for participation in the study.
• • Patients who are expected to stay in intensive care for at least 48 hours
• Exclusion Criteria:
• • The patient has an identified pregnancy or suspected pregnancy.
• • Presence of thrombocytopenia that may prevent catheter placement (platelet count less than 50 thousand/mm3 and not being able to be increased)
• • Prolongation of prothrombin time that may prevent catheter placement
• • Prolongation of activated partial thromboplastin time that may prevent catheter placement
• • Failure to provide jugular or subclavian central venous catheterization
• • Clinical conditions that prevent the insertion of an arterial thermistor catheter (edema, hematoma, thrombosis, signs of active infection in the area where the catheter will be inserted) and the inability to insert an arterial thermistor catheter
• • The patient is receiving CRRT (Continuous renal replacement therapy)/ECMO (Extracorporeal membrane oxygenation)
• • Contraindications to passive leg raising test (axial fractures, intra-abdominal hypertension, increased intra-abdominal pressure, lower extremity amputation)
• • Presence of conditions preventing bedside USG (chest wall deformity, inability to position the patient appropriately, inadequate image quality, open wound, infection or dressing on the chest wall preventing transthoracic USG)
• • Objection of patients' intensivist to enroll the patient (with a documented reason)