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Volume Responsiveness By Ultrasound Of Carotid Blood Flow In Patients With Cardiogenic Shock

NCT05271227 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 40

Last updated 2022-03-08

No results posted yet for this study

Summary

Resuscitation of critically ill patients has changed since the advent of goal directed therapy. Today, practitioners providing fluid resuscitation are attentive of the danger associated with volume depletion while being aware of the morbidity of volume overload. Fluid resuscitation must be rapid, precise, and individually tailored to each patient based on reliable data obtained by various means inside ICU setting.

There is no non-invasive method that can reliably and accurately identify fluid responsiveness. As such, in patients with undifferentiated shock, treatment often involves empiric fluid administration, in the hopes that volume expansion will increase preload, which will then serve to increase cardiac output (CO). However, for patients on the flat portion of the Starling curve, aggressive fluid administration results in no appreciable increase in CO and may be detrimental to hemodynamically unstable patients.

Conditions

  • Cardiogenic Shock
  • Volume Responsiveness
  • Ultrasound

Interventions

OTHER

Transthoracic echocardiography and Carotid artery doppler (PHILIPS HD11 XE ultrasound device) before and after PLR test.

VTI-LVOT was measured by echo by placing the pulsed wave Doppler sample gate in the LVOT diameter in apical-5-chamber window. VTI-LVOT was obtained by manually tracing the Doppler velocity spectrum. LVOT velocity time integral was recorded before and after PLR test within 2 minutes. Carotid blood flow was measured by using two-dimensional image, the optimal image of the long-axis view was obtained at the common carotid artery. The sample volume was placed on the center of the lumen, 2 cm proximal to the bulb, and a pulsed wave Doppler examination,The angle correction cursor was placed parallel to the direction of blood flow. A PLR will be performed in 2 sequential steps, first step patient is seated in the semi recumbent position (45°) then using an automatic bed elevation technique, the lower limbs will be then raised to a 45° angle while the patient's trunk will be lowered in supine position. Thus, the angle between the trunk and the lower limbs will remain unchanged (135°).

Sponsors & Collaborators

  • Alexandria University

    lead OTHER

Principal Investigators

  • Ahmed M ElMenshawy, Lecturer · University of Alexandria

Eligibility

Min Age
18 Years
Max Age
75 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2020-03-25
Primary Completion
2021-02-20
Completion
2021-03-20

Countries

  • Egypt

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05271227 on ClinicalTrials.gov