Actively Recruiting
Evaluation of Right Atrial Reservoir Strain Variation and Fluid Responsiveness in Septic Shock Patients
Led by Centre Hospitalier Universitaire, Amiens · Updated on 2024-07-10
250
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
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
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
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Single day during ICU stay within 48 hours of septic shock diagnosis
Participants undergo transthoracic echocardiography (TTE) before and after passive leg raising and fluid challenge maneuvers as part of routine care. These non-invasive imaging procedures are performed at the bedside with no additional follow-up.
1 extended TTE session with multiple image acquisitions
Trial Site Locations
Total: 1 location
1
CHU Amiens Picardie
Amiens, France
Actively Recruiting
Research Team
C
Christophe Beyls, MD
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
OTHER
Number of Arms
1
Frequently Asked Questions
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