Intubated Patients Clinical Trial
Official title:
Transthoracic Echocardiographic Assessment of the Superior Vena Cava Flow Respiratory Variation in ICU Intubated Patients
Acute circulatory failure is frequent, affecting up to one-third of patients admitted to
intensive care units (ICU). Monitoring hemodynamics and cardiac function is therefore a major
concern. Analysis of respiratory diameter variations of the superior vena cava (SVC) is
easily obtained with transesophageal echocardiography (TEE) and is helpful to assess fluid
responsiveness.
Transthoracic echocardiography (TTE) exploration of the SVC is not used in routine. Recently,
micro-convex ultrasound transducers have been marketed and these may be of use for
non-invasive SVC flow examination. However, analysis of diameter variations of the SVC with
TTE does not seem to be possible since the approach from the supraclavicular fossa does not
allow for a good visualization of the SVC walls.
It was recently demonstrated in a short pilot study that TTE examination of the SVC flow with
a micro-convex ultrasound transducer (GE 8C-RS) seems both easy to learn and to use
(feasibility = 84.9%), and is reproducible in most ventilated ICU patients with an intraclass
correlation coefficient for the systolic fraction of the superior vena cava flow of 0.90 (95%
confidence interval [0.86-0.93]).
The hypothesis is that cardio-respiratory interactions in intubated-ventilated patients are
responsible of SVC flow variations and that the analysis of the SVC flow respiratory
variations could be a new predictive tool of fluid responsiveness.
n/a
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