Brachial Artery Peak Velocity Variation to Predict Fluid Responsiveness

Hospital del SAS de Jerez38 enrolled

Overview

The investigators designed this study to determine the predictive value for predicting fluid responsiveness of noninvasive evaluation of respiratory variation of peak velocity in brachial artery, in mechanically ventilated patients with acute circulatory failure.

Predicting the hemodynamic response to fluid administration (or fluid responsiveness) in critical ill patients is still a matter of concern, since fluid overload could worse the clinical situation of these patients. Parameters of fluid responsiveness usually require an invasive monitoring (like arterial pulse pressure variation). We hypothesize that noninvasive evaluation of respiratory variation of peak velocity in brachial artery using Doppler ultrasound could provide a feasible estimation on fluid responsiveness in mechanically ventilated patients with acute circulatory failure.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Hypotension Shock

Interventions

Fluid administrationOTHER

500 ml of synthetic colloid (Voluven®, hydroxyethylstarch 6%; Fresenius, Bad Homburg, Germany) infused over 30 minutes

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with controlled mechanical ventilation, equipped with an indwelling radial artery catheter and for whom the decision to give fluids will be taken because the presence of one or more clinical signs of acute circulatory failure: * systolic blood pressure \<90 mmHg (or a decrease \>50 mmHg in previously hypertensive patients) * the need of vasopressor drugs * oliguria (urine output \<0.5 ml/kg/min for at least 2 h) * tachycardia * delayed capillary refilling * the presence of skin mottling Exclusion Criteria: * Contraindication for the volume administration: evidence of fluid overload and/or of hydrostatic pulmonary edema * Patients with instable cardiac rhythm

Locations (1)

Hospital del SAS de Jerez

Jerez de la Frontera, Cádiz, Spain

Outcomes

Primary Outcomes

Predictive value of respiratory variation in brachial artery peak velocity before volume expansion assessed by ROC curve. We defined responser as patients that increased stroke volume index equal or more than 15% after fluid administration.

Time frame: immediately after volume expansion

Secondary Outcomes

Evaluate the predictive value of pulse pressure variation for predicting hemodynamic response to fluid administration, comparing with the predictive value of respiratory variation of brachial artery peak velocity.

Time frame: immediately after fluid administration

Evaluate the predictive value of stroke volume variation for predicting hemodynamic response to fluid administration, comparing with the predictive value of respiratory variation of brachial artery peak velocity.

Time frame: immediately after volume expansion

Data from ClinicalTrials.gov

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