Evaluation of Corrected Carotid Flow Time Variations During Passive Leg Lift to Predict Response to Filling.

Centre Hospitalier de Cornouaille21 enrolled

Overview

Patients hospitalized in intensive care often require intravenous administration of fluid in order to optimize the functioning of the heart and thus ensure perfusion of vital organs such as the kidneys, the brain or the digestive tract. However, it is necessary to find the right balance in fluid intake because it has been shown that excessive administration has a negative impact on patient survival, the length of their stay in intensive care or the duration of invasive mechanical ventilation.The passive leg lifting maneuver is regularly used to determine which patients should be infused with these large volumes (the patient's chest is placed in a horizontal position and the legs are elevated at 30 ° by tilting the bed for 2 minutes ). To be interpreted, this maneuver requires the presence of invasive devices (bloody arterial pressure catheter, PICCO monitor) or an operator experienced in cardiac ultrasound.Our study aims to evaluate an easy-to-use, non-invasive tool widely available in intensive care and emergency departments (carotid vascular doppler ultrasound) to assess the response to a passive leg lifting maneuver. . The measurements are taken before and after a passive leg lifting maneuver and then before and after a filling decided before inclusion by the doctor responsible for the patient.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Organ Failure, Multiple

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * equipped with a PICCO2® continuous cardiac output monitoring device * for which the practitioner in charge of the patient decides to administer a volume expansion Exclusion Criteria: * patients whose rhythm is non-sinus * who have expressed their refusal to participate in the protocol * contraindicated to passive leg lifting maneuvers (deep vein thrombosis, HTIC, BMI\> 40 or\> 14, spinal instability) * pregnant women and patients clinically suspected of abdominal compartment syndrome

Outcomes

Primary Outcomes

response to filling

Collection of the diagnosis of response to filling after volume expansion of 500mL of Isotonic Salted Serum and evaluation of the variation in TFCc during passive leg lifting between the two groups

Time frame: 90sec

Secondary Outcomes

cut-off value for positivity of the test

The secondary objective of this work is to determine the best positivity threshold value of the test studied as well as its sensitivity and specificity for the chosen value.