The study will examine the ability of renal ultrasound (Doppler and Contrast Enhanced Ultrasound (CEUS)) in distinguishing ICU patients who exhibit increases in glomerular filtration rate (GFR) in response to fluid loading, from those for whom fluid loading is without benefit of directly harmful.
The study will examine the ability of renal ultrasound (Doppler and Contrast Enhanced Ultrasound (CEUS)) in distinguishing ICU patients who exhibit increases in GFR in response to fluid loading, from those for whom fluid loading is without benefit of directly harmful. Patients available for inclusion will receive a baseline administration of Tc-99-DTPA for precise determination of GFR/renal function by blood and urine samples. Baseline values of ultrasound measures will be obtained, including renal arterial, renal venous, portal venous and hepatic venous Doppler measures and renal contrast enhanced ultrasound (CEUS) will also be recorded. After two hours, baseline values of GFR are finished. The patient is then exposed to passive leg raising and ultrasound measures are repeated, including renal arterial, renal venous, portal venous and hepatic venous Doppler measures. The participant then receives a standardised fluid bolus of 7 ml/kg (ideal body weight) Once the fluid bolus administration is complete, renal ultrasound is repeated, including renal arterial, renal venous, portal venous, hepatic venous Doppler measures and renal CEUS. Follow-up determination of GFR/renal function based on Tc-99-DTPA after fluid therapy is repeated with blood and urine samples.
Study Type
OBSERVATIONAL
Enrollment
2
The participant receives IV fluid as a standardised bolus of 7 ml/kg (ideal body weight).
Aarhus University Hospital, Department of Anaesthesiology
Aarhus, Denmark
Changes in renal function in response to a standardised fluid bolus.
Renal function is measures as Tc-99-Diethylenetriaminepentaacetic acid (DTPA) clearance.
Time frame: 6 hours
Renal venous flow classification
normal - abnormal (pulsatile/biphasic/monophasic
Time frame: 6 hours
Renal venous impedance index
(maximum flow velocity - minimum diastolic flow velocity) / maximum flow velocity
Time frame: 6 hours
Renal venous stasis index
(index cardiac cycle time - venous flow time) / index cardiac cycle time
Time frame: 6 hours
Renal arterial resistive index
(maximum flow velocity - minimum diastolic flow velocity) / maximum flow velocity
Time frame: 6 hours
Portal venous pulsatility fraction
(maximum flow velocity - minimum diastolic flow velocity) / maximum flow velocity
Time frame: 6 hours
Contrast enhanced ultrasound 1
Mean transit time (mTT)
Time frame: 6 hours
Contrast enhanced ultrasound 2
Perfusion Index (PI)
Time frame: 6 hours
Contrast enhanced ultrasound 3
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Relative Blood Volume (rBV)
Time frame: 6 hours
Contrast enhanced ultrasound 4
Wash-in Rate (WiR)
Time frame: 6 hours
Contrast enhanced ultrasound 5
Quality Of Fit (QOF)
Time frame: 6 hours
Continuous recordings of hemodynamic variables 1
arterial pressure
Time frame: 6 hours
Continuous recordings of hemodynamic variables 2
Central venous pressure
Time frame: 6 hours