The goal of this observational study is to see if repeated bedside ultrasound measurements of the lungs and abdomen as well as a blood vessel in the neck can be done in patients with advanced liver disease and ascites (fluid in the abdomen) on hospital wards and day case units. We will also learn about how patients view this test. The main questions it will answer are: How long does it take to do the measurements? How often are we able to get all the measurements we are trying to do? How do patients feel about having this test done? For patients in the study this will involve: Undergoing ultrasound scans of the neck, chest and abdomen on at least one occasion during hospital admission, and up to a maximum of five times in a day. An extra blood test may be taken at the same time as usual blood tests taken during the hospital stay. A brief questionnaire about their experience of having the test.
Study Type
OBSERVATIONAL
Enrollment
100
Point-of-care ultrasound measurements of the IJV, IVC, thorax and abdomen performed at least once following recruitments and on up to three separate occasions in total during the first seven days of admission, with up to five measurements in total on each occasion.
A blood sample for research analysis may be taken at the same time as standard of care blood tests during the study.
Technical success or failure of POCUS readings
The number of POCUS scans attempted that resulted in a recorded measurement
Time frame: From enrollment until the end of the POCUS readings period at 7 days
Duration of POCUS readings
Time taken to perform each episode of POCUS during the study period, defined by the start and end times recorded in the case report form
Time frame: From enrolment until the end of the POCUS readings period at 7 days
Patient acceptability
Structured feedback from participants on the acceptability of the POCUS readings via a questionnaire
Time frame: From enrollment until the end of the POCUS readings period at 7 days
Changes in POCUS measurements in response to fluid management interventions
The delta of POCUS readings before and after fluid management interventions (intravenous fluid or albumin, diuretics, terlipressin or large volume paracentesis)
Time frame: From enrolment until the end of POCUS readings period at 7 days
Correlation of POCUS readings with clinical assessment
A descriptive analysis of how frequently baseline clinical assessments agreed with POCUS findings suggestive of hypovolaemia or hypervolaemia
Time frame: From enrolment until end of POCUS readings period (7 days)
Correlation of POCUS readings with clinical outcomes
A descriptive analysis of POCUS parameters and predefined clinical outcomes (emergency readmission to hospital, renal dysfunction, fluid overload/pulmonary oedema, variceal bleeding, hepatic encephalopathy, other organ dysfunction/ACLF grade, ICU admission and death)
Time frame: From enrolment until 90 days
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