Hemodynamic optimization of critically ill patients is a goal for clinicians in order to afford the patient the best possible outcomes. Being able to precisely and rapidly determine patient fluid responsiveness provides the bedside physician and nursing staff the information needed to make critical decisions in regard to the patient's fluid status and management of additional fluids and medications. As fluid management and cardiac output determination are linked to better decision-making and improved outcomes in ICU, the use of a dynamic assessment of fluid responsiveness becomes a key tool for patient management. This study is designed to collect treatment and outcome data on patients that have undergone hemodynamic monitoring during CRRT therapy.
Study Type
OBSERVATIONAL
Starling is a portable, non-invasive, cardiac output detector system. The Starling monitor measures the cardiac output by employing electrical bioreactance. Bioreactance is a measure of the electrical characteristics of a volume of tissue and fluid. In the case of cardiac output measurements, the relevant tissue includes the heart and the immediate surrounding volume of the thorax. The relevant fluid is blood. The Starling electrode is a double electrode sensor. Within each sensor, one electrode is used to transmit a high frequency sine wave into the body, while the resulting voltage is measured at the adjacent electrode. This information is used to determine cardiac output. The Starling monitor also measures and displays associated hemodynamic parameters based on calculations of measurements already incorporated into the Starling monitor.
Baxter Investigational Site
Lexington, Kentucky, United States
Change in stroke volume (SV) after CRRT initiation
Time frame: Day 1 (during CRRT)
Change in cardiac output (CO) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in cardiac index (CI) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in stroke volume (SV) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in stroke volume index (SVI) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in Thoracic Fluid Content (TFC) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in heart rate (HR) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in systolic blood pressure (SBP) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in diastolic blood pressure (DBP) after fluid removal
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Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in central venous pressure (CVP) after fluid removal
Cardiac physiology adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in mixed venous oxygen saturation (SVO2) after fluid removal
Perfusion parameter adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Change in lactate after fluid removal
Perfusion parameter adjusted to net ultrafiltration intensities (ml/kg/h)
Time frame: Day 1 (during CRRT)
Changes in systolic blood pressure (SBP) from beginning to end of CRRT
Time frame: Day 1 (Begin CRRT) through Day 1 (End of CRRT)
Changes in diastolic blood pressure (DBP) from beginning to end of CRRT
Time frame: Day 1 (Begin CRRT) through Day 1 (End of CRRT)
Changes in mean arterial pressure (MAP) from beginning to end of CRRT
Time frame: Day 1 (Begin CRRT) through Day 1 (End of CRRT)
Incidence of intradialytic hypotension (IDH) during CRRT
Time frame: Day 1 (during CRRT)
Incidence of intradialytic hypotension (IDH) free time during CRRT
Time frame: Day 1 (during CRRT)
Incidence of time to resolution in intradialytic hypotension (IDH) during CRRT
Time frame: Day 1 (during CRRT)
Changes in intake and output (I/O) during CRRT
Fluid balance parameter
Time frame: Day 1 (during CRRT)
Changes in hourly/daily fluid balance during CRRT
Time frame: Day 1 (during CRRT)
Changes in cumulative fluid balance during CRRT
Time frame: Day 1 (during CRRT)
Changes in percent fluid overload during CRRT
Fluid balance parameter
Time frame: Day 1 (during CRRT)
Changes in ultrafiltration parameters and net ultrafiltration (UFnet) during CRRT
Time frame: Day 1 (during CRRT)
Incidence of ultrafiltration failure during CRRT
Including prescribed/archived, time to fluid balance
Time frame: Day 1 (during CRRT)
Blood flow rate during CRRT
Time frame: Day 1 (during CRRT)
CRRT dose/modality
Time frame: Day 1 (during CRRT)
Estimate the contribution degree of certain patient conditions, clinical characteristics, fluid, and CRRT parameters in predicting the IDH risk during CRRT
Time frame: Day 1 (during CRRT)
Identify sub-phenotypes of patients at risk of IDH during CRRT
Time frame: Day 1 (during CRRT)