Septic Shock Clinical Trial
— PIVAOfficial title:
Observational Study to Evaluate Peripheral IntraVenous Analysis (PIVA) in Euvolemic, Hypovolemic, and Hypervolemic Emergency Department Patients
NCT number | NCT03736421 |
Other study ID # | 2018P000494 |
Secondary ID | |
Status | Suspended |
Phase | |
First received | |
Last updated | |
Start date | November 10, 2018 |
Est. completion date | April 2021 |
Verified date | June 2020 |
Source | Beth Israel Deaconess Medical Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The overall goal of this multicenter project is to characterize the expected normal range of Peripheral IntraVenous Volume Analysis (PIVA) values during a euvolemic state, and how those ranges may be altered by comorbidities; the relationship between PIVA and intravenous volume administration during resuscitation of infected patients with presumed hypovolemia; and, the relationship between PIVA and volume decreases during diuresis in acute heart failure patients with hypervolemia.
Status | Suspended |
Enrollment | 280 |
Est. completion date | April 2021 |
Est. primary completion date | April 2021 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Control Cohort (Presumed Euvolemia) Inclusion Criteria: - Age > 18 years old - Assessed as "euvolemic" by treating physician Exclusion Criteria: - History of any type of decreased oral intake or volume loss (e.g. diarrhea, vomiting, etc) - History of a fever - History of bleeding - Any acute illness expected to alter volume - Known or suspected pregnancy - Active irregular heart rhythm - In the opinion of the treating physician, no anticipated intravenous fluid administration - History of chronic or end stage renal disease - Liver failure - History of Acute heart failure - Presence of abnormal vital signs (90 < HR < 60; 180 < SBP < 110, respiratory rate > 20, pulse ox < 92% or need for supplemental oxygen, 99.0 < temperature < 96). 2 additional group will be included in this euvolemic group - Non-elderly patients (age < 50 year) without any comorbid illnesses and - Age >65 - Diabetes on medications - Hypertension on medications - Vascular disease defined by history of peripheral vascular disease, stroke, MI Note: patients that receive >250 cc of IVF will be excluded from analysis. Infection Cohort (Presumed Hypovolemia) Inclusion Criteria: - Age > 18 years old - An accessible intravenous catheter is in place - Known or suspected infection as assessed by the clinical team - Intention to admit to the hospital - Anticipated administration of intravenous fluids per clinical team Exclusion Criteria: - Clinical exam consistent with volume overload - Known or suspected pregnancy - Patients with a history of chronic renal insufficiency or end-stage renal disease - Patients with a history of acute heart failure Acute Heart Failure (Hypervolemic cohort) Inclusion Criteria: - Age > 17 years old - An accessible intravenous catheter is in place - Primary clinical diagnosis of CHF - Meet 2 of the three criterion: - X-ray diagnosis - Elevated bnp from known baseline - Clinical diagnosis - Received or intent to administer a diuretic agent - Intent to admit to the hospital for anticipated > 24 hour period Exclusion Criteria: - History of any type of decreased oral intake or volume loss (e.g. diarrhea, vomiting, etc) - History of a fever - History of bleeding - Known or suspected pregnancy - Active irregular heart rhythm - History of dialysis dependent end stage renal disease |
Country | Name | City | State |
---|---|---|---|
United States | Beth Israel Medical Center | Boston | Massachusetts |
United States | University of Washington | Seattle | Washington |
United States | St. Vincent Hospital | Worcester | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Beth Israel Deaconess Medical Center | Baxter Healthcare Corporation |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Association between PIVA measurement and fluid status (net gain vs net loss) | Change in fluid status over the first 6 hours as measured by weight and urine output and pressure status from the Edwards transducer | Baseline to 6 hours for euvolemic and hypovolemic cohort, and baseline to 72 hours for hypervolemic cohort | |
Secondary | Response to Passive leg raise | Compute the change in PIVA measurement between before and after the passive leg raise challenge within each cohort | For the euvolemic cohort, baseline to 2 hours; For hypovolemic, cohort baseline to 6 hours; for the hypervolemic cohort, baseline up to 72 hours | |
Secondary | Association between PIVA and non-invasive monitoring responsiveness to passive leg raise | Compare change in PIVA measurements to non-invasive monitoring measurements before and after passive leg raise and before and after fluid boluses | Baseline up to 72 hours |
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