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.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Rémi Schweizer, Dr
- Telefoonnummer: 0033472357093
- E-mail: remi.schweizer@chu-lyon.fr
Studie Locaties
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Bron, Frankrijk, 69500
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon
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Contact:
- Rémi Schweizer, Dr
- Telefoonnummer: 0033472357093
- E-mail: remi.schweizer@chu-lyon.fr
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Hoofdonderzoeker:
- Rémi Schweizer, Dr
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Patients admitted to the ICU
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: COHORT
- Tijdsperspectieven: PROSPECTIVE
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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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 |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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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
Tijdsspanne: 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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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 69HCL26_0902
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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