The Validity of Peripheral Perfusion Index to Predict Fluid Responsiveness
The Validity of Peripheral Perfusion Index to Predict Fluid Responsiveness Using Mini-fluid Challenge Test
Studieoversikt
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Detaljert beskrivelse
The concept of fluid responsiveness has been suggested to guide fluid administration in critically ill patients to avoid either over or under-transfusion.
Several methods have been suggested to detect fluid responsiveness. Mini fluid challenge with concomitant monitoring of stroke volume is one of the most robust methods for pre-load challenge.
The main foreshortening of mini fluid challenge method is the need for a real-time cardiac output monitor, to track the instantaneous change of stroke vole with changing body position. Finding a surrogate to cardiac output to trace the effect of mini fluid challenge would make the test more applicable without the need for advanced hemodynamic monitors.
There is a growing interest in the use of perfusion indices in assessment of fluid responsiveness. Perfusion indices are measures for adequacy of oxygen delivery in peripheral tissues; thus, they were hypothesized to be possible surrogates of cardiac output. Peripheral perfusion index represents "the ratio between the pulsatile and non-pulsatile component of the light reaching the pulse oximeter" . Peripheral perfusion index has been considered as a numerical non-invasive measure for peripheral perfusion. PPI has the advantage over other perfusion indices that it a non-invasive, user-friendly monitor.
The aim of this work is to investigate the ability of peripheral perfusion index to predict the hemodynamic response to mini-fluid challenge in patients with septic shock.
Mini-fluid challenge test will be performed by infusion of 200 mL Lactated Ringer's solution over 1 minute. Velocity time integral will be monitored using Transthoracic echocardiography at the left ventricular outflow tract at the apical five-chamber view. Cardiac output will be calculated, and the patient will be considered fluid-responder if cardiac output increased by 10% after fluid challenge.
Studietype
Registrering (Faktiske)
Kontakter og plasseringer
Studiesteder
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Cairo, Egypt, 11432
- Ahmed Mohamed Hasanin
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Deltakelseskriterier
Kvalifikasjonskriterier
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Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
Inclusion Criteria:
- Septic shock patients
Exclusion Criteria:
- Evident blood loss
- Peripheral vascular disorders
- Upper limb injury or burns
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Peripheral perfusion index
Tidsramme: 2 hours
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It is a number describing the ratio between pulsatile and non-pulsatile blood flow measured by pulse oximeter.
It is measured in percent.
with the best value of 20% and the worst value of 0.1%
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2 hours
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Velocity time integral
Tidsramme: 2 hours
|
it is a parameter measured from Doppler across the left ventricular outflow tract.
It is calculated by dividing the blood velocity by time and measured in cm
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2 hours
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Mean arterial blood pressure
Tidsramme: 2 hours
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Mean arterial blood pressure measured in mmHg
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2 hours
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Central venous pressure
Tidsramme: 2 hours
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Central venous pressure measured from a central venous catheter.
It is measured in cmH2o
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2 hours
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Systolic arterial blood pressure
Tidsramme: 2 hours
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Systolic arterial blood pressure measured in mmHg
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2 hours
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Diastolic arterial blood pressure
Tidsramme: 2 hours
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Diastolic arterial blood pressure measured in mmHg
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2 hours
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Cardiac output
Tidsramme: 2 hours
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The amount of blood pumped by the heart in one minute.
it is measured as liters per minute
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2 hours
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Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Studieleder: Ahmed Shash, Professor, Head of department of anesthesia, Cairo University, Egypt
Publikasjoner og nyttige lenker
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Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- N-138-2018
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