Respiratory Variations For Predicting Fluid Responsiveness 2 (ReVaPreF2)
Diagnostic Accuracy of the Inferior Vena Cava Collapsibility to Predict Fluid Responsiveness in Spontaneously Breathing Patients With Sepsis, Acute Circulatory Failure, and Irregular Cardiac Rhythm
Objectives: To investigate whether respiratory variations of inferior vena cava diameters (cIVC) predict fluid responsiveness in spontaneously breathing patients with septic acute circulatory failure and irregular heartbeats.
Design: Prospective, bicentric study, intensive care units.
Patients and measures: Spontaneously breathing patients with sepsis and clinical signs of acute circulatory failure are included. A positive response to fluid loading (FL) is defined as an increase of the stroke volume (SV) >10%. The investigators measured the minimum inspiratory and maximum expiratory diameters of the IVC (idIVC and edIVC) during standardized (st) and unstandardized (ns) breathing. The investigators calculated cIVCst and cIVCns before a 500ml-colloid FL.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Lille, France
- Intensive Care Department, Salengro Hospital,CHRU
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult patients of the intensive care units of the Lille university-hospital and of the Valencienne general hospital.
- Age greater than or equal to 18.
- Patient insured
- Spontaneous breathing without ventilatory support or intubation or tracheotomy.
- Irregular cardiac rhythm
- Prescription by the physician in charge of the patients of a 500 mL volume expansion in less than 30 minutes.
Patients with sepsis with at least one sign of acute circulatory failure:
- Tachycardia with heart rate> 100/min
- systolic blood pressure <90mmHg or a decrease >40mmHg in previously hypertense patient
- Oliguria <0.5ml/kg/hour for at least one hour
- skin mottling
Exclusion Criteria:
- high-grade aortic insufficiency
- transthoracic echogenicity unsuitable for measuring the stroke volume or inferior vena cava diameters
- clinical signs of active exhalation
- clinical or ultrasonographic evidence of pulmonary edema due to heart failure
- pregnancy
- abdominal compartment syndrome
- regular cardiac rhythm
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Echocardiography-Doppler
Ultrasonographic recordings, systemic arterial pressure, heart rate, and respiratory rate are recorded immediately before and after volume expansion (VE), performed as a 30-minute infusion of 500 mL of 4% gelatin.
Inferior Vena Cava diameters are measured during spontaneous and standardized respiratory cycles.
Stroke volume is measured during spontaneous respiratory cycles.
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Ultrasonographic recordings are recorded immediately before and after volume expansion (VE), performed as a 30-minute infusion of 500 mL of 4% gelatin.
Inferior Vena Cava diameters are measured during spontaneous and standardized respiratory cycles.
Stroke volume is measured during spontaneous respiratory cycles.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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respiratory variations in inferior vena cava diameters with respect to the response to fluid resuscitation, assessed by the area under the ROC curve
Time Frame: during 30 minutes of the volume expansion
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during 30 minutes of the volume expansion
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Sebastien Preau, MD, PhD, University Hospital, Lille
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2011_46
- 2011-A01598-33 (Other Identifier: ID-RCB number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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