What is this study trying to find out about fluid responsiveness in septic shock?

This study is investigating whether changes in right atrial reservoir strain can identify which septic shock patients respond to fluid treatment. The goal is to improve fluid management by using transthoracic echocardiography measurements. The research is sponsored by Centre Hospitalier Universitaire, Amiens and focuses on better predicting fluid responsiveness to avoid unnecessary treatments.

Who may be eligible for this septic shock clinical trial?

Adults aged 18 and older with septic shock for less than 48 hours may be eligible. Participants must be on mechanical ventilation and require fluid resuscitation, with blood pressure monitored by arterial catheter. Both genders can participate. Please review eligibility criteria for more details.

Is there any cost to participate in this septic shock clinical trial?

Study-related care, including the echocardiography procedure and all trial visits, is provided at no cost. However, personal travel expenses may vary and are not guaranteed to be covered. Participants can expect all study procedures to be performed at the bedside without additional charges.

Actively Recruiting

Phase Not Applicable

Age: 18Years +

All Genders

ID06492044

Study on Using Right Atrial Reservoir Strain Changes to Predict Fluid Response in Adults with Septic Shock

Led by Centre Hospitalier Universitaire, Amiens · Updated on 2024-07-10

250

Participants Needed

Research Sites

N/A

Total Duration

AI-Summary

What this Trial Is About

Researchers are evaluating how changes in right atrial reservoir strain RASr can help identify fluid responsiveness in patients with septic shock. The study focuses on determining if variations in RASr after a fluid challenge or passive leg raising PLR maneuver can predict increases in cardiac output. This is important for managing fluid treatment to avoid unnecessary administration in critically ill septic shock patients. Participants will undergo transthoracic echocardiography TTE at several time points before and after the PLR maneuver, and before and after a fluid challenge. These procedures are routine for septic shock care but will be repeated as part of the study to measure changes in cardiac output and RASr. The TTE is non-invasive, painless, and performed at the bedside with no known risks. During the study, patients will have TTE scans at baseline, and at 10, 30, and 45 minutes after fluid challenge or PLR. The main outcome measured is the change in RASr value after fluid challenge. Secondary outcomes include comparisons of stroke volume, central venous pressure, and right ventricular function. No additional follow-up or contact is required after the final TTE scan. The study concludes once all measurements are collected.

CONDITIONS

Brief Title

Evaluation of the Association Between Right Atrial Reservoir Strain Variation and Fluid Responsiveness in Patients With Septic Shock

Who Can Participate

Age: 18Years +

All Genders

Eligibility Criteria

You may qualify if you...

Adult patient older than 18 years
Hospitalized in Intensive Care Unit with septic shock for less than 48 hours
Presence of sepsis, hypotension requiring vasopressors to maintain mean arterial pressure ≥ 65 mmHg despite prior fluid resuscitation, and blood lactate levels > 2 mmol/l
Requires fluid resuscitation with crystalloids or colloids
On invasive mechanical ventilation in assisted-controlled mode
Blood pressure monitored via radial or femoral arterial catheter connected to MostCareUp
Patient or family informed and non-opposition documented

You will not qualify if you...

Poor echocardiographic image quality preventing right atrial strain assessment
Contraindication to passive leg raising maneuver such as severe head trauma or intracranial hypertension
History of pericardiectomy
Clinical signs of abdominal compartment syndrome
Aortic pathology, mitral or tricuspid regurgitation greater than grade 2, mitral stenosis, or intracardiac shunt
Internal or external atrial or ventricular pacing
Pregnant woman
On extracorporeal membrane oxygenation or mechanical circulatory support
Moribund patient
Supraventricular or ventricular arrhythmia during echocardiographic measurements
On renal replacement therapy during echocardiographic examination

Research Team

Christophe Beyls, MD

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