Point of Care Ultrasonography In The Management of Shock: A Pilot Study

Western University, Canada50 enrolled

Overview

This project aims to determine the feasibility of conducting a randomized controlled trial investigating point of care ultrasound guided resuscitation compared with usual care in the management of shock at the Critical Care Trauma Centre (CCTC) in London Health Science Centre (LHSC).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Shock Hypotension

Interventions

PoCUS Guided Resuscitation of ShockOTHER

Point-of-care ultrasound (PoCUS) will be used to guide resuscitation of the participant with shock. A PoCUS study will consist of limited echocardiography (LE) and thoracic ultrasound (TUS).

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Patients deemed by the clinician to be in shock for any reason and has 3 out of 4 of the following: 1. Lactate greater than or equal to 2.2 mmol/L 2. AKIN stage I or greater or Urine output less than 0.5 cc/hr 3. Altered level of consciousness due to shock or requiring invasive mechanical ventilation as a result of shock 4. Vasoactive agents required to maintain a mean arterial pressure greater than 65 mmHg. Exclusion Criteria: 1. Pregnant patients 2. Participants who have already undergone a PoCUS study (as defined in the protocol for this study) within the past 48 hours 3. Participants who have restrictions on their goals of care at the time of ICU admission (including patients refusing blood products). 4. Patients post cardiac arrest who are not obeying commands

Locations (1)

London Health Science Center - Critical Care Trauma Center

London, Ontario, Canada

Outcomes

Primary Outcomes

Recruitment rate

Number of patients who were successfully enrolled in the study per given week.

Time frame: averaged over 48 week period (active recruitment taking place in 48 of those 52 weeks)

Secondary Outcomes

Mortality

proportion of patients who are deceased for any reason at 28 days

Time frame: 28 days

Successful randomization rate

proportion of eligible patients who were randomized within the window for enrolment

Time frame: 28 days

Protocol adherence rate

Proportion of participants in the intervention arm that received the intended intervention

Time frame: 28 days

Contamination rate

Proportion of participants who were randomized to the control arm and inadvertently received the intervention

Time frame: 28 days

Revoked deferred consent rate

Proportion of participants whose consent was revoked

Time frame: 28 days

ICU length of stay

total days spent in ICU from time of admission to time of patient discharge

Time frame: 28 days

Ventilator free days

Days alive and free of mechanical ventilation at 28 days

Time frame: 28 days

Data from ClinicalTrials.gov

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