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- Essai clinique NCT02846948
The Impact of Focused Transthoracic Echocardiography in Urgent Abdominal Surgery for Septic Patients (ECHOCARD)
The Impact of Extended Hemodynamic Monitoring by Focused Transthoracic Echocardiography in Urgent Abdominal Surgery for Septic Patients
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Often sepsis remains undiagnosed at the very beginning because of the concentration to the surgical pathology in perioperative period. This results in unacceptably high mortality. The investigators hypothesize that extended hemodynamic monitoring by focused transthoracic echocardiography will personalize early fluid resuscitation which will improve patient's outcome.
The goals of the investigators study are:
- To conduct two-group randomized controlled clinical trial to compare patient management based on standard monitoring and extended hemodynamic monitoring by focused transthoracic echocardiography in patients undergoing urgent abdominal surgery due to peritonitis.
- To demonstrate that patient management based on extended hemodynamic monitoring by focused echocardiography results in improved survival, reduced incidence of hemodynamic instability during perioperative period.
- To compare an amount of administrated of intravenous fluids in both groups.
The investigators hypothesize that focused echocardiography monitoring will result in more administrated intravenous fluids during perioperative period.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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A. Mickeviciaus Street 9
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Kaunas, A. Mickeviciaus Street 9, Lituanie, LT-44307
- Lithuanian university of health sciencies
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Age more than 18 years old.
- Patients undergoing urgent abdominal surgery due to diffuse peritonitis.
- SOFA score >2.
- Patients who sign an agreement to participate in the study.
Exclusion Criteria:
- Younger than 18 years old.
- Known pregnancy.
- Unconscious patients or those who do not agree to participate in the study.
- Contraindication to central venous or arterial catheterization.
- Patients who were already treated in ICU because of sepsis or septic shock before this surgery.
- Known chronic renal failure.
- Re-laparotomy.
- Peritonitis due to acute mesenteric ischaemia, thrombosis or trauma.
- Dying patients.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Aucune intervention: Non-echo group
Patients get the standard monitoring and treatment based on Good medical practice.
Extended monitoring by focused echocardiography is not applied for this group.
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Expérimental: Focussed echocardiography group
The extended cardiac monitoring by focused assessed transthoracic echocardiography is applied.
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Focused assessed transthoracic echocardiography is non-invasive, painless procedure.
The transducer is placed on the chest at certain locations and angles to get the required information on patient's condition.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Inpatient mortality in both treatment arms.
Délai: 30 days intra-hospital mortality
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Comparison of 30 days intra-hospital mortality in both arms.
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30 days intra-hospital mortality
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Comparison of incidence of severe hypotension MAP <65 mmHg after anaesthesia induction in both arms.
Délai: 1-5 minutes after anaesthesia induction.
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To evaluate the incidence of severe hypotension after anesthesia induction (1 - 5 minutes after induction) in both groups.
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1-5 minutes after anaesthesia induction.
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Comparison of fluid management in both arms (from hospitalisation to the surgery, during the surgery, after the surgery up to 24 hours).
Délai: up to 24 hours
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Comparison of tow fluids management strategies.
Usual monitoring group - fluid management based on fluid responsiveness based by clinical sings.
FATE group - fluid management based on focused transthoracic echocardiography data.
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up to 24 hours
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Comparison of septic shock incidence in both arms.
Délai: up to 30 days
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To compare the manifestation of septic shock (hemodynamics instability not responding to fluid administration, which requires norepinephrine infusion to maintain MAP ≥ 65 mmHg);
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up to 30 days
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Number of ICU-Free days.
Délai: up to 30 days
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To compare ICU free days in both groups.
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up to 30 days
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Andrius Macas, profesor, Lithuanian university of health sciencies
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- MIP051/2015
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
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