Critically Ill Clinical Trial
Official title:
Evaluation of the Validity of a New Index Provided by the PiCCO2 Device for Predicting Fluid Responsiveness in Critically Ill Patients
Fluid therapy is an important part of the management of patients with hemodynamic
instability in the intensive care unit. By increasing cardiac preload, it aims at elevating
cardiac output (CO) and thus restoring hemodynamic conditions in patients who are preload
responsive. By contrast, volume administration can be deleterious in terms of pulmonary
edema formation or other manifestations or fluid overload, especially in patients who are
not preload responsive. Functional dynamic parameters that use heart-lung interactions, such
as pulse pressure variation (PPV) and stroke volume variation (SVV) are considered accurate
predictors of preload responsiveness in patients receiving fully controlled mechanical
ventilation.
However, in cases of spontaneous breathing activity where heart-lung interaction indices
fail to predict fluid responsiveness, one needs parameters able to reliably predict the
hemodynamic response of fluid administration.
A new index that could indicate fluid responsiveness, so-called the fluid responsiveness
index (FRI), has been elaborated. The advantage is that it could be used in patients who are
not in control mechanical ventilation as well as in patients who are fully adapted to
mechanical ventilation.
The FRI is based upon the analysis of continuous arterial and continuous central venous
pressure. The FRI is determined by the relation of cardiac and respiratory activity; both
are evaluated by means of power spectrum analysis of the pressures recorded.
The aim of this study is to test the value of the FRI to predict the hemodynamic response to
fluid infusion in patients with hemodynamic instability not receiving fully controlled
mechanical ventilation.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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