Predicting Fluid Responsiveness Using Transiently Increased Intrathoracic Pressure in Mechanically Ventilated Patients
Completed · Not applicable
Conditions studied: Fluid Reponsiveness
In brief
The goal of this study is to identify in patients requiring active fluid resuscitation and mechanical ventilation for circulatory shock, can a controlled increase in intrathoracic pressure (either by positive-end expiratory pressure (PEEP) or tidal volume (TV)) predict responsiveness to additional fluid resuscitation. We hypothesize that a temporary, physiologically-safe increase in positive-end expiratory pressure (PEEP) and/or a temporary increase in tidal volume (from 6 cc/kg predicted body weight (PBW) to 8 cc/kg PBW) in patients requiring invasive mechanical ventilation will predict fluid responsiveness based upon an assessment of the change in pulse pressure and stroke volume variation.
Key facts
- Study ID
- NCT03413657
- Run by
- University of California, Davis
- People needed
- 5
- Starts
- 2017-12-27
- Expected to finish
- 2018-09-13
- Last updated by the study team
- 2020-01-18
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Mechanically ventilated
- Identified by treatment team as requiring intravenous fluid bolus
- Acute circulatory failure during admission (systolic blood pressure (SBP) ≤90 mmHg or mean arterial pressure (MAP) ≤70 mmHg or requiring vasopressors to maintain SBP >90 mmHg or MAP >70 mmHg, along with one or more of the following:
- urinary flow ≤0.5 mL/kg/min for ≥2 hours,
- heart rate ≥100 beats per minute
- presence of skin mottling
- blood lactate concentration ≥4 mmol/L
You may not qualify if…
- Contraindication to fluid bolus
- Assynchrony Index > 10%
- Clinically significant cardiac arrhythmia
- Severe valvular heart disease
- Chest tubes with air leak
- Abdominal compartment syndrome
- Pregnancy
- Concurrent nebulized medication or inhaled nitric oxide
- Transthoracic echogenicity unsuitable for measuring velocity-time integral of aortic blood flow (SVI)
- Prisoner
- Clinical brain death
- PEEP > 15 cmH2O
Where it is running
- University of California, Davis — Sacramento, California, United States
Full record on ClinicalTrials.gov
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