Breathing Clinical Trial
— VPVCOfficial title:
Diagnostic Accuracy of the Central Venous Pressure (CVP) Variation to Predict Fluid Responsiveness in Spontaneously Breathing Patients
Volume expansion (VE) is often administered in intensive care (ICU)-patient to improve
arterial oxygen delivery. Such effect is secondary to an increase in stroke volume and
cardiac output. However, cardiac output increase in response to VE (fluid responsiveness)
only occurs when the heart is preload-dependant. Increasing evidence of the deleterious
effects of inappropriate fluid administration encourages the development of variables
predicting fluid responsiveness, but few have been validated in spontaneously breathing
patients.
Central venous pressure (CVP) variation in spontaneously patients during standardized or
unstandardized inspiratory maneuver may represent an easy tool to predict fluid
responsiveness. The hypothesise is that inspiratory maneuver may increase CVP variation in
fluid responsiveness patient whereas no or few variation may reflect fluid unresponsiveness.
Status | Recruiting |
Enrollment | 68 |
Est. completion date | February 2021 |
Est. primary completion date | February 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria - Spontaneous breathing without mechanical assistance - Central venous catheter (superior vena cava) and monitoring of central venous pressure - Urinary catheter and monitoring of intra-abdominal pressure Exclusion Criteria: - Intolerance to ventilatory manœuvre including Severe basal dyspnea/Symptomatic heart failure (pulmonary edema) - Contraindication to passive leg raising (intracranial hypertension) - Passive leg raising unsuitable for measuring hemodynamic response : High grade aortic insufficiency/ Poor echogenicity unsuitable to measure the velocity-time /integral of aortic blood flow/ Pregnancy/Abdominal hypertension with abdominal compartment syndrome/ Lower leg amputation - Necessity of urgent hemodynamic therapy (within 90 min) - Modification of hemodynamic therapy during study protocol (vascular filling, increase catecholamine dose |
Country | Name | City | State |
---|---|---|---|
France | Hôpital Roger Salengro, CHU | Lille |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Lille |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | the area under the ROC curve of the "CVPV-st" parameter | Diagnostic accuracy of the CVPV during a standardized inspiratory maneuver (CVPV-st) to predict fluid responsiveness. | an average 60 - 90 minute during the procedure | |
Secondary | the area under the ROC curve of the "CVPV-un" parameter | Diagnostic accuracy of the CVPV during an unstandardized inspiratory maneuver (CVPV-un) to predict fluid responsiveness. | an average 60 - 90 minute during the procedure |
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