Consistency of Fluid Tolerance Evaluation Methods and Their Correlation With Clinical Outcomes in Patients With Shock

N/AEnrolling By InvitationNCT07373717

Southeast University, China45 enrolled

Overview

This study aims to explore the feasibility and scientific validity of carotid-jugular Doppler in evaluating volume tolerance in shock patients (with the VExUS score as an important reference standard), and to conduct an in-depth analysis of the correlation between its monitoring indicators and patient prognosis.The primary endpoint is comparison of the agreement between hands-free carotid-jugular Doppler and the VExUS score in evaluating volume tolerance.The secondary endpoint is correlation between volume tolerance assessed by hands-free carotid-jugular Doppler and the clinical outcomes of shock patients.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Shock

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Shock patients admitted to the ICU are defined as those with persistent hypotension (systolic blood pressure \< 90 mmHg or a decrease of ≥ 40 mmHg from the baseline blood pressure) accompanied by signs of tissue hypoperfusion. * Age ≥ 18 years old. * The patient or their legal representatives signed the informed consent form. Exclusion Criteria: * Patients with severe pulmonary circulatory disorders such as severe pulmonary hypertension and acute pulmonary embolism. * Patients with right ventricular myocardial infarction or severe tricuspid regurgitation. * Patients with severe neck trauma or deformity that affects Doppler examination of cervical arteries and veins, or those with anatomical contraindications preventing evaluation of at least one cervical artery or vein. * Pregnant or lactating women. * Patients with diseases that may interfere with abdominal ultrasound examination.

Locations (1)

Outcomes

Primary Outcomes

Hands-free Carotid Artery and Vein Doppler Parameters

Elevate the patient's upper body to 45°, keep the legs flat, place the long axis of the probe perpendicular to the carotid vessels (with the probe height not exceeding the upper edge of the thyroid cartilage), locate the optimal signals of the common carotid artery and internal jugular vein waveforms, and then fix the probe.

Time frame: Time of shock in ICU within 3 days

Secondary Outcomes

PiCCO

Inject cold saline through central venous catheterization, sense temperature changes via arterial catheter, and obtain hemodynamic parameters such as cardiac output by combining thermodilution and pulse contour analysis.

Time frame: Time of shock in ICU within 3 days

Venous Excess Ultrasound Score

Evaluate the diameter, waveform, etc. of the inferior vena cava, hepatic veins, portal vein, and intrarenal veins sequentially via ultrasound, and comprehensively derive a grade ranging from 0 to 3.Grade 0: No congestion; Grade 1: Mild congestion; Grade 2: Moderate congestion; Grade 3: Severe congestion.

Time frame: Time of shock in ICU within 3 days

Bioelectrical Impedance Analysis

Attach electrodes to the patient's limbs, input basic information, measure impedance of multiple parts with multi-frequency technology, and quickly obtain parameters such as body composition.

Time frame: Time of shock in ICU within 3 days

Duration of shock

Time of shock in ICU within 28 days

Time frame: Time of shock in ICU within 28 days

Duration of Mechanical Ventilation

Duration of Mechanical Ventilation During ICU Admission

Time frame: up to 24 weeks

Total Length of Hospital Stay

Time frame: up to 24 weeks

Length of ICU stay

Time frame: up to 24 weeks

mortality of 28 days

Incidence of death during 28 days

Time frame: Incidence of death during 28 days

In-hospital Mortality

Time frame: up to 24 weeks

Vasoactive Agent Dosage

Vasoactive Agent Dosage During ICU Admission

Time frame: up to 24 weeks

Time without vasoactive agents within 28 days

Time frame: Time without vasoactive agents within 28 days