- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03621618
Clinical Assessment of Arterial Dynamic Elastance in ICU Patients, Dependent on Inotropic or Vasopressor Drugs.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Assessment of the cardiovascular status and haemodynamics comprise directly or indirectly cardiac output, which is determined by left ventricular preload, contractility, afterload and heart rate. Various haemodynamic monitors have been introduced in anaesthesia and ICU practice, providing cardiac output either non-invasively or invasively. The combined use of arterial pressure monitoring with these devices provides insight not only in cardiac output but offers bedside assessment of most determinants of cardiovascular function. Both pulse pressure variation (PPV) and stroke volume variation (SVV) have been described as dynamic descriptors of fluid responsiveness, a measure allowing optimization of preloading conditions if haemodynamics show signals of insufficient perfusion.
Arterial load can be assessed based on a two-element Windkessel model with a static and dynamic component. The static part consists of a resistive element (systemic vascular resistance: SVR = (MAP/C0)*80, with MAP, mean arterial pressure; CO, cardiac output) and a pulsatile component (net arterial compliance C = SV/arterial pulse pressure with SV, stroke volume). Arterial elastance is considered being an integrative variable, associating both steady elements and heart rate (Ea = .9*SAP/SV with EA, arterial elastance; SAP, systolic arterial pressure). The dynamic component Eadyn is the ratio of PPV and SVV during a mechanical ventilator cycle, providing a functional assessment of ventriculo-arterial coupling.
Combined use of arterial pressure tracing (or its non-invasive surrogate) and (non-) invasive stroke volume actually may provide an interesting framework for haemodynamic monitoring and subsequent optimization in many surgical, postoperative or ICU patients. This study aims to copy as good as possible the handling and the way of management as in a clinical setting.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Vlaams Brabant
-
Jette, Vlaams Brabant, Belgium, 1090
- Recruiting
- Universitair Ziekenhuis Brussel
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ICU patients, treated/supported with noradrenalin or dobutamine.
Exclusion Criteria:
- Septic shock
- Aortic valve regurgitation and defect of septum
- Severe aortic sclerosis, aortic prosthesis
- Severe hypertension (MAP > 130 mmHg)
- Cardiac arrhythmia
- Tachycardia with a heart rate higher than 150 bpm
- Age below 18 or above 75 y
- Patient height below 120 cm (48") or above 230 cm (90")
- Patient weight less than 30 kg (67 lbs.) or greater than 155 kg (341 lbs.)
- Intra-aortic balloon pump
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: dobutamine
Cardiac failure
|
evaluation of effects of dobutamine on dynamic arterial elastance in cardiac failure
|
Other: norepinephrine
Sepsis
|
evaluation of effects of norepinephrine on dynamic arterial elastance in sepsis
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change of Dynamic Arterial Elastance (Eadyn)
Time Frame: baseline and from 30-90 minutes after increase with 20% of vasoactive medication and haemodynamic stabilisation
|
display on the hemodynamic monitor
|
baseline and from 30-90 minutes after increase with 20% of vasoactive medication and haemodynamic stabilisation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Eadyn estimation on haemodynamic monitor
Time Frame: from 30 to 90 minutes after increase with 20% of vasoactive medication
|
display on the hemodynamic monitor
|
from 30 to 90 minutes after increase with 20% of vasoactive medication
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: jan Poelaert, PhD, MD, Universitair Ziekenhuis Brussel
- Study Chair: Michel Vervoort, IR, Universitair Ziekenhuis Brussel
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Heart Failure
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Protective Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Cardiotonic Agents
- Adrenergic beta-Agonists
- Sympathomimetics
- Adrenergic beta-1 Receptor Agonists
- Vasoconstrictor Agents
- Norepinephrine
- Dobutamine
Other Study ID Numbers
- Eadyn project 2
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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