RecruitingNCT06390423

Passive Leg Raise and Mini-fluid Challenge Effect on Various Cardiac Output Surrogates for Fluid Responsiveness

Passive Leg Raise and Mini-fluid Challenge Effect on Various Cardiac Output Surrogates Such as Pulse Pressure Variation (PPV), End-tidal CO2 (Carbon Dioxide), Bioreactance (Stroke Volume Index -SVI) and Velocity Time Integral on Echocardiographic Exam for Fluid Responsiveness in Patients With Moderately Severe ARDS (Acute Respiratory Distress Syndrome)

Sponsor

CentraCare

Enrollment

64 participants

Start Date

Jul 1, 2023

Study Type

OBSERVATIONAL

Conditions

Fluid responsiveness

Summary

In the critically ill population, fluid administration in an unstable patient is perhaps the most common intervention that is performed. Uncorrected hypovolemia with inappropriate vasopressors lead to organ hypoperfusion where as overzealous fluid administration especially in ARDS (Adult respiratory distress syndrome) can increase mortality. It has been estimated that only 50% of hemodynamically unstable critically ill patients are volume responsive, hence dynamic assessment of preload responsiveness has been proposed to better identify those individuals who would benefit from fluid bolus.

Eligibility

Min Age: 30 YearsMax Age: 90 Years

Inclusion Criteria4

Age between 30 - 90 years
Diagnosis of Vasodilatory Shock with no other obvious cause of hypotension
Diagnosis of ARDS with PF ratio < 150 , PEEP > 8
Patients who are under paralysis or deeply sedated, on a mechanical ventilator

Exclusion Criteria6

Patients with arrhythmias including atrial fibrillation
Patients with chest tube, intra-abdominal hypertension or with its risk factors
Patients with structural heart disease including pulmonary hypertension (RVSP > 45) and heart failure
Patients on extracorporeal support such as ECMO, CRRT or MCS.
Patients with COPD with a premorbid FEV1 < 1.5 L
Severe atherosclerotic vascular disease