Ultrasonic Diagnosis Clinical Trial
Official title:
Non-invasive Assessments of Central Venous Pressure by Ultrasound and Clinical Examination: a Prospective Comparative Study
Background: Estimates of central venous pressure (CVP) can be very helpful in guiding fluid
therapy in the intensive care unit, operating room or emergency room. Current standard
technique for CVP assessment is invasive, requiring insertion of a catheter into a
subclavian, internal jugular or peripheral vein. Several ultrasound based and clinical
methods have been described as potential non-invasive alternatives to assess CVP.
Aim: To prospectively evaluate the accuracy of CVP assessment by a) inferior vena cava
diameter and collapsibility b) internal jugular vein diameter c) compression sonography of a
forearm vein and d) clinical assessment of peripheral vein collapse in comparison to
invasive CVP measurement.
Study design: single center, prospective observational study
Patients and Methods:
We will examine 77 consecutive patients with invasive venous access and invasive hemodynamic
monitoring at the surgical intensive care unit (ICU). After obtaining informed consent,
ultrasound examinations of the inferior vena cava, internal jugular vein and compression
sonography of a forearm vein as well as clinical evaluation of peripheral vein
collapsibility will be performed in a random sequence by different experienced examiner.
Invasive CVP is recorded simultaneously to each measurement. Examiners are blinded to
clinical parameters and results of previous CVP measurements.
Primary endpoint: Accuracy of each non-invasive method to determine CVP defined by
invasively measured CVP.
Secondary endpoint: Comparison of the feasibility of each non-invasive method.
Expected results: We hypothesize that sonographic measurement of inferior vena cava
diameter, internal jugular vein diameter and compression sonography of a forearm vein as
well as clinical assessment of peripheral vein collapsibility are reliable methods for CVP
determination in comparison to invasive CVP measurement.
Significance: The validation and comparison of sonographic / clinic CVP assessment would
enable clinicians to choose an accurate non-invasive method to assess volume status which is
an important adjunct in the management of many critically ill patients. The non-invasiveness
of these methods broadens the feasibility to measure CVP and may guide fluid therapy in new
patient populations.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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