Clinical Trials Logo

Clinical Trial Summary

Fluid overload increases morbidity and mortality of pediatrics patients in intensive care unit (ICU). It could be interesting to predict the decrease in stroke volume when diuretics are prescribed. Nevertheless, no test predict a decrease of stroke volume in a context of a diuretics induced depletion. Abdominal compression (AC) coupled with echocardiographic measurement of the stroke volume can predict fluid responsiveness and is a good tool to assess preload dependency. Another point is that during depletion refilling can occur. We aim to assess the diagnostic accuracy of abdominal compression to predict a decrease of the stroke volume of 15 % during diuretic-induced depletion of 10 ml/kg of diuresis. Secondary outcome will assess the hemoconcentration during depletion to diagnose a decrease of stroke volume during diuretic induced depletion


Clinical Trial Description

Fluid overload increases morbidity and mortality of pediatrics patients in intensive care unit (ICU). The pediatric intensivist has a priority to decrease unnecessary fluid load and to make the fluid balance negative in case of fluid overload. Diuretics help to make the fluid balance negative but can lead to a reduction of volemia that can lead to hypovolemia. Hypovolemia can induce a reduction of stroke volume and cardiac index that can alter tissue perfusion and increase organ dysfunction.

It could be interesting to predict the decrease in stroke volume when diuretics are prescribed. Nevertheless, no test predict a decrease of stroke volume in a context of a diuretics induced depletion.

The concept of preload dependency described by frank-starling is interesting in that context.

Preload dependency is a state of the working heart characterized by a modification of stroke volume when a modification of preload is done. Conversely, no preload dependency is a state of the working heart characterized by no modification of stroke volume when a modification of preload is done.

If the heart is in a state of preload dependency, a reduction of preload induced by diuretics depletion might induce a reduction of stroke volume. Conversely, if the heart is in a state of no preload dependency a reduction of preload induced by a diuretics depletion might not induce a reduction of stroke volume Abdominal compression coupled with echocardiographic measurement of the stroke volume can predict fluid responsiveness and is a good tool to assess preload dependency.

Another point is that during depletion refilling can occur. Studies performed during hemodialysis have shown that refilling maintains a stable hematocrit during depletion. the absence of refilling is characterized by an hemoconcentration

We aim to assess the diagnostic accuracy of abdominal compression to predict a decrease of the stroke volume of 15 % during diuretic induced depletion of 10ml/kg of diuresis. Secondary outcome will assess the hemoconcentration during depletion to diagnose a decrease of stroke volume during diuretic induced depletion ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03145935
Study type Observational
Source Hopital Louis Pradel
Contact Matthias Jacquet-Lagreze, M.D., M.Sc.
Phone +33 6 89 10 99 59
Email matthias.jl@gmail.com
Status Recruiting
Phase
Start date May 10, 2017
Completion date December 2019

See also
  Status Clinical Trial Phase
Completed NCT04095143 - Ultrasound Markers of Organ Congestion in Severe Acute Kidney Injury
Terminated NCT03335124 - The Effect of Vitamin C, Thiamine and Hydrocortisone on Clinical Course and Outcome in Patients With Severe Sepsis and Septic Shock Phase 4
Completed NCT05070819 - Atrial Natriuretic Peptide in Assessing Fluid Status N/A
Withdrawn NCT04870073 - Retrograde Autologous Priming and Mannitol for Reducing Hemodilution in Cardiac Surgery Phase 3
Recruiting NCT02989051 - Fluid Restriction Keeps Children Dry Phase 2/Phase 3
Completed NCT00852514 - The Optimization of Blood Pressure and Fluid Status Control With Eight-Polar Bioelectrical Impedance Analysis Phase 4
Completed NCT00517127 - Crystalloids Versus Colloids During Surgery Phase 4
Not yet recruiting NCT05983549 - Neutral Versus Liberal fLuId In Traumatic Brain Injury: a Randomised Controlled Trial N/A
Completed NCT03929471 - Target Weight Correction and Vascular Stiffness in Hemodialysis Patients N/A
Recruiting NCT06071026 - Hemodynamic Effects of Variations in Net Ultrafiltration Rate During Continuous Renal Replacement Therapy. N/A
Completed NCT02903316 - Predicting Fluid Responsiveness in on Pump Coronary Artery Bypass Graft Using Extra Systoles N/A
Terminated NCT02458157 - Forced Fluid Removal in High Risk Acute Kidney Injury Phase 4
Completed NCT02325856 - Application of Bioimpedance Spectroscopy in Taiwan Dialysis Patients N/A
Completed NCT01628731 - Furosemide Versus Ethacrynic Acid in Children With Congenital Heart Disease Phase 3
Not yet recruiting NCT05647200 - Optimization of Prime Fluid Strategy to Preserve Microcirculatory Perfusion During Cardiac Surgery With Cardiopulmonary Bypass, Part II N/A
Completed NCT03768752 - Diastolic Dysfunction and Interstitial Lung Edema in Septic Patients
Terminated NCT03553394 - Effects of Restrictive Fluid Strategy on Postoperative Oliguric Pancreatic Surgery Patients N/A
Completed NCT06097923 - Implementation of Fluid Strategies Using Real-time Bioelectrical Analyzer in Surgical Intensive Care Unit (SICU) N/A
Recruiting NCT04215692 - Lung Ultrasound-guided Fluid Therapy in Pediatric Intensive Care Unit Patients N/A
Not yet recruiting NCT03322410 - Hydratation Status at Initiation of Peritoneal Dialysis: Study of the Role of Peritoneal Permeability N/A