This is a prospective observational study to observe the diagnostic efficacy of a quantitative ultrasound assessment plan for pathological accumulation in the abdominal cavity space of critically ill patients, and to explore its correlation with patient clinical outcomes.
Intra-abdominal lesions, such as hemorrhage and inflammation/infection, often lead to pathological accumulations, posing serious challenges for critically ill patients. These lesions can rapidly induce intra-abdominal hypertension and organ damage, which may progress to hemorrhagic or septic shock, endangering patients\' lives. Intra-abdominal hemorrhage, especially surgery-related hemorrhage, is difficult to detect early, and existing assessment methods like CT scans have limited applicability in critically ill patients. Intra-abdominal infections account for a high proportion of infections in critically ill patients, with concurrent sepsis or shock having high mortality rates. Despite advancements in critical care medicine, the mortality rate from intra-abdominal infections remains stubbornly high. Accurate assessment of the source and extent of infection is crucial for treatment, yet routine physical examinations have low sensitivity in critically ill patients, making imaging examinations the primary method. However, while abdominal CT is considered the gold standard, it is limited by insufficient dynamic monitoring and difficulties in patient transport. Bedside ultrasound plays a significant role in the monitoring of critically ill patients due to its portability, non-invasiveness, and real-time dynamic capabilities. It can assess sources of hemorrhage and infection, quantify the extent of lesions, and monitor hemodynamic changes. Therefore, this study aims to develop a comprehensive ultrasound assessment protocol that covers the peritoneal cavity and posterior peritoneal space. Through a prospective observational study, we aim to validate its sensitivity and specificity in diagnosing pathological accumulations such as intra-abdominal hemorrhage/infection and explore its correlation with patient clinical outcomes.
Study Type
OBSERVATIONAL
Enrollment
125
Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China
Quantitative CT Scoring for Pathological Accumulations in the Abdominal Cavity Space
score range from 0-20, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Quantitative Ultrasound Scoring for Pathological Accumulations in the Abdominal Cavity Space
score range from 0-20, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Time to initiate enteral nutrition
Time to initiate enteral nutrition after admission to ICU in hours
Time frame: up to 3 days after admission to ICU
Intra-abdominal pressure
Intra-abdominal pressure in mmHg
Time frame: up to 3 days after admission to ICU
C-reactive protein
C-reactive protein in mg/L
Time frame: up to 3 days after admission to ICU
procalcitonin
procalcitonin in ng/L
Time frame: up to 3 days after admission to ICU
white blood cell count
white blood cell count
Time frame: up to 3 days after admission to ICU
time to achieve enteral nutrition targets
time to achieve enteral nutrition targets in hours
Time frame: up to 28 days after admission to ICU
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serum albumin
serum albumin in g/L
Time frame: up to 28 days after admission to ICU
prealbumin
prealbumin in mg/L
Time frame: up to 28 days after admission to ICU
Duration of Continuous Renal Replacement Therapy treatment
Duration of CRRT (Continuous Renal Replacement Therapy) treatment in hours
Time frame: up to 28 days after admission to ICU
duration of mechanical ventilation
duration of mechanical ventilation in hours
Time frame: up to 28 days after admission to ICU
length of ICU stay
length of ICU stay in days
Time frame: up to 28 days after admission to ICU
prognosis
survival or death when transfer out of the ICU
Time frame: up to 28 days after admission to ICU
acute physiology and chronic health evaluation II score
score range from 0-71, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Sequential Organ Failure Assessment
score range from 0-15, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Abdominal Gastrointestinal Index score
score range from 0-4, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Abdominal Gastrointestinal Index Ultrasonography Score
score range from 0-10, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
Gastrointestinal Ultrasound Scoring score
score range from 0-10, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU
semi-quantitative ultrasound score of gastric content
score range from 0-2, higher scores indicate a worse outcome
Time frame: up to 3 days after admission to ICU