Capillary Refill Time Variation to Predict Oxygen Comsumption Variation After FLuid Challenge (CARTOFL) (CARTOFL)
Circulatory shock is characterized by tissue hypoxia. Although fluid resuscitation is an essential treatment in many forms of circulatory shock, its benefits are variable, and its administration carries a risk of potentially harmful fluid overload.
Assessment of fluid responsiveness generally relies on changes in cardiac output. However, the actual therapeutic objective is rather to improve tissue oxygen utilization, as reflected by oxygen consumption. Despite its physiological relevance, direct measurement of oxygen consumption remains complex and difficult to perform in routine clinical practice.
Capillary refill time is a simple, rapid, non-invasive, and readily available marker of peripheral perfusion. It is associated with outcomes in patients with circulatory shock, and a capillary refill time-guided therapeutic strategy may improve outcomes in patients with septic shock.
This study hypothesizes that changes in capillary refill time following fluid resuscitation may predict changes in oxygen consumption induced by fluid administration. If confirmed, capillary refill time and its changes could be incorporated into the criteria used to assess the indication for fluid resuscitation in patients with shock. They would also provide additional physiological information regarding the relationship between peripheral perfusion and oxygen consumption.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Rémi Schweizer, Dr
- Phone Number: 0033472357093
- Email: remi.schweizer@chu-lyon.fr
Study Locations
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Bron, France, 69500
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon
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Contact:
- Rémi Schweizer, Dr
- Phone Number: 0033472357093
- Email: remi.schweizer@chu-lyon.fr
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Principal Investigator:
- Rémi Schweizer, Dr
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Patients admitted to the ICU
Description
Inclusion Criteria :
- Adult patient admitted to the intensive care unit within the previous 72 hours
- Receiving invasive mechanical ventilation
- For whom the clinician plans to perform a fluid challenge
- No objection from the participant or a relative/legally authorized representative
Exclusion Criteria :
- Fraction of inspired oxygen greater than 60%
- Administration of inhaled medications, including nitric oxide
- Positive end-expiratory pressure greater than 15 cmH₂O
- Excessive leaks in the ventilator circuit, defined as an expired volume less than 95% of the inspired volume
- Patient receiving mechanical circulatory support involving a gas exchanger
- Patient receiving renal replacement therapy
- Administration of sodium bicarbonate within the 2 hours preceding inclusion
- Disconnection from the ventilator anticipated before the end of the study
Study Plan
How is the study designed?
Design Details
- Observational Models: COHORT
- Time Perspectives: PROSPECTIVE
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Patients
The patients targeted by this study are mechanically ventilated intensive care patients for whom the attending clinician plans to perform a fluid challenge. |
Setup of an indirect calorimetry measurement |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Assessment of the ability of fluid challenge-induced changes in capillary refill time to predict fluid challenge-induced changes in oxygen consumption
Time Frame: Day 0
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Area under the receiver operating characteristic curve of changes in capillary refill time for predicting a 15% increase in oxygen consumption during a fluid challenge |
Day 0
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 69HCL26_0902
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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