Echocardiographic Prediction of Fluid Responsiveness After a Mini-fluid Challenge in Non-ventilated Patients With Shock

Centre Hospitalier Universitaire de Nīmes71 enrolled

Overview

The main objective of this study is to show that the variation of the subaortic velocity time integral after a mini test by filling 100 cc of normal saline over 1 minute (ΔITV100) is predictive of response to filling (defined as an increase in aortic velocity time integral measured by transthoracic ultrasound over 15% after administration of 500 cc of normal saline over 15 minutes) in non-ventilated shock patients.

The secondary objectives of this study include: * To determine the sensitivity and specificity of the variation of the velocity time integral after administration of 100 cc of normal saline over 1 minute (ΔITV100) to predict the response to the filling. * To study the inter-observer variation of ΔITV100 measurement. * To compare ΔITV100 to other clinical and radiological parameters for predicting response to filling (initial value of the subaortic velocity time integral, variation in mitral E wave, E / A, respiratory variation of the diameter of the inferior vena cava, marbling clinical evolution score.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Shock Circulatory Failure

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The patient must have given his/her informed and signed consent * The patient must be insured or beneficiary of a health insurance plan * Systolic blood pressure (SBP) \< 90 mmHg * Signs of inadequate cardiac output: urine output \<0.5 ml / kg / h for more than two hours, hyperlactataemia * Requires amines to maintain an SBP ≥ 90 mmHg or inability to lower amines or requires an increase in amines Exclusion Criteria: * The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * The patient (or his/her person-of-trust) refuses to sign the consent * It is impossible to correctly inform the patient * The patient is pregnant, parturient, or breastfeeding * The patients has a contraindication for a treatment necessary for this study * Cardiogenic shock * Acute pulmonary edema * Moribund patient * Non echogenic patient * Patient with cardiac arrhythmia * Patients for whom the passive leg raising test is contraindicated (hyper intra-abdominal pressure, pelvic or lower limb trauma)

Locations (1)

CHU de Nîmes - Hôpital Universitaire Carémeau

Nîmes, France