Actively Recruiting
Evaluation of the Association Between Right Atrial Reservoir Strain Variation and Fluid Responsiveness in Patients With Septic Shock
Led by Centre Hospitalier Universitaire, Amiens · Updated on 2024-07-10
250
Participants Needed
1
Research Sites
216 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Evaluating preload dependence is crucial for managing fluid administration in septic shock patients. To avoid unnecessary fluid administration, it's recommended to use dynamic tests like the passive leg raising (PLR) maneuver or a fluid challenge (FC) to see if a patient's cardiac output will increase after fluid resuscitation. Transthoracic echocardiography (TTE) is preferred for this because it can non-invasively, reliably, and reproducibly measure the increase in cardiac output. A patient is considered a "responder" if their stroke volume (SV) increases by more than 15% after an FC. Two-dimensional (2D) right atrial strain (RAS) is a promising tool for evaluating right atrial function. According to the Frank-Starling law, measuring changes in the RA reservoir strain phase (RASr) can identify acute changes in preload, like those induced by a PLR maneuver or an FC. The aims of this study are to assess the ability of ∆RASr to identify responders after a fluid challenge (FC) and to evaluate the ability of ∆RASr variation induced by a PLR maneuver to distinguish responders from non-responders to volume expansion.
CONDITIONS
Official 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 (>18 years old)
- Hospitalized in Intensive Care Unit at Amiens University Hospital with septic shock for less than 48 hours, defined by sepsis, hypotension needing vasopressors to maintain mean arterial pressure 6 65 mmHg despite prior fluid resuscitation, and blood lactate > 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 device
- 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 regurgitation > grade 2, tricuspid regurgitation > 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 measurement
- On renal replacement therapy during echocardiographic examination
AI-Screening
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Trial Site Locations
Total: 1 location
1
CHU Amiens Picardie
Amiens, France
Actively Recruiting
Research Team
C
Christophe Beyls, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
OTHER
Number of Arms
1
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