Role of Echocardiography in Guiding Fluid Therapy in Shocked Patients With Impaired Cardiac Contractility in Emergency Department

Shock Clinical Trial

Official title:

Role of Echocardiography in Guiding Fluid Therapy in Shocked Patients With Impaired Cardiac Contractility in Emergency Department

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05488730
• Other study ID #: Echo in fluid therapy 2022
• Status: Completed
• Phase: N/A
• Start date: August 1, 2021
• Est. completion date: August 3, 2022

Study information

• Verified date: August 2022
• Source: Alexandria University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

fluid therapy is one of the cornerstones in the management of shock but may result in iatrogenic fluid overload .The aim of this study was to assess the role of echocardiography in guiding fluid therapy in shocked patients with impaired cardiac contractility using straight leg raising test ,Inferior vena-cava collapsability index and Doppler imaging in Emergency Department in Alexandria main university hospital.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 100
• Est. completion date: August 3, 2022
• Est. primary completion date: July 30, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• shocked patient with impaired cardiac contractility

Exclusion Criteria:

• Trauma patients.

• Patient with unstable arrhythmias.

• Patients with lower limb amputation.

• Mechanically ventilated patients.

• Patients with prosthetic aortic valve.

• Patients less than 18 years old

• Pregnant.

Related Conditions & MeSH terms

• Emergencies
• Shock

Intervention

Diagnostic Test:
• passive leg raising test and fluid challenge
Shocked patients were subjected to echocardiographic examination if (EF <52%) .baseline LVOT VTI was obtained Then IVC scanning was done through subcostal Window and using M-mode the minimum and the maximum diameters were measured then the collapsibility index was calculated Then passive leg raising test was done Patients who tolerated the PLR test and did not develop clinical or lung ultrasound signs of fluid overload (lung congestion) were given IV fluid bolus (250 ml normal saline) over 10 minutes followed by measurement of LVOT VTI. Patients who did not tolerate PLR test or developed clinical or lung ultrasound signs of fluid overload (lung congestion) during PLR test were excluded from the third step (fluid challenge). The differentiating factor used to allocate patient in which group (non-responder or responder) was LVOT VTI variability after fluid challenge (our gold standard to assess fluid responsiveness).

Locations

Country	Name	City	State
Egypt	Faculty of Medicine	Alexandria

Sponsors (1)

Lead Sponsor	Collaborator
Alexandria University

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	LVOT VTI variability	variability of LVOT VTI to determine fluid responsiveness	15 minutes