Comparison of 250 ml Versus 500 ml of Fluid Challenge

Centre Hospitalier Universitaire, Amiens24 enrolled

Overview

The objective of fluid challenge is to increase oxygen delivery (DO2) in order to improve/restore tissue oxygen consumption (VO2). However the fluid challenge volume to administer stills in debate, some studies recommend to administer 250 mL. Previous studies suggested that 500 mL of fluid challenge administration may improve cardiac output and oxygen delivery. The relation between the amount of fluid expansion and oxygen delivery and oxygen consumption was not yet been studied in a randomized study in critical care patients. This is the purpose of this study.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Fluid Challenge Oxygen Consumption Critical Care

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient for whom the physician in charge decided to infuse fluid challenge because of signs of acute circulatory failure (systolic arterial blood pressure \< 90mmHg, and/or mean arterial blood pressure\< 65 mmHg, and/or the need of vasopressive amine infusion, and/or skin mottling, and/or diuresis \<0.5 mL/kg/h for more than 2 hours, and/or arterial lactate level\>2mmol/L. * Echogenic patient * Patient with a Stroke Volume (SV) variation with passive leg raising (PLR) more than 10%. * Patient with regular sinus rhythm. * Patient who received protocol information. Exclusion Criteria: * Age Under 18-year-old. * Pregnancy.

Outcomes

Primary Outcomes

VO2 after fluid challenge

Tissue oxygen consumption (VO2) after fluid challenge

Time frame: 30 minutes after fluid challenge.

VO2 after fluid challenge

Tissue oxygen consumption (VO2) after fluid challenge

Time frame: 60 minutes after fluid challenge.

Secondary Outcomes

Change of arterial lactate concentration from baseline

Baseline is the measurement of arterial lactate concentration immediately after fluid challenge

Time frame: 30 minutes after fluid challenge.

Change of arterial lactate concentration from baseline

Baseline is the measurement of arterial lactate concentration immediately after fluid challenge

Time frame: 60 minutes after fluid challenge.

Respiratory variation of stroke volume

Respiratory variation of stroke volume after fluid challenge.

Time frame: Immediately, 30 and 60 minutes after fluid challenge.

PaO2/FiO2

PaO2/FiO2 ratio (ratio of arterial oxygen partial pressure to fractional inspired oxygen) after fluid challenge

Time frame: Immediately, 30 and 60 minutes after fluid challenge.

Respiratory variation of the pulse pressure

Time frame: 30 and 60 minutes after fluid challenge.

Stroke volume variation with passive leg raising (PLV)

Time frame: 30 and 60 minutes after fluid challenge.

Systolic heart function (LVEF)

Time frame: Immediately, 30 and 60 minutes after fluid challenge.

Diastolic heart function

Diastolic heart function (E, A, E', A', S' waves)

Time frame: Immediately, 30 and 60 minutes after fluid challenge.

Comparison of 250 ml Versus 500 ml of Fluid Challenge

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes