Strainy trauma: Acute Myocardial Dysfunction and Chest Trauma - The Strainy Trauma Study
Study Details
Study Description
Brief Summary
This study aims to investigate whether the identification of acute myocardial dysfunction by 2D-strain transthoracic sonography in the first week following trauma would allow to better diagnose occult and severe patterns of myocardial contusion, in order to identify a subpopulation at higher risk of complications.
The measurement of myocardial strain (2D-strain) by transthoracic sonography is a robust tool to assess the myocardial function.
The investigators strongly suppose that the 2D-strain would allow to better identify subclinical MC in chest trauma, as well as the severe patterns that are associated with more organs dysfunctions and a worst outcome.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
|
Detailed Description
Thoracic trauma is the cause of significant morbidity and accounts for 25% of trauma-related deaths.
The myocardial contusion (MC) is a distinct injury, which has a prevalence increasing with the severity of the trauma. The diagnostic tool is a major factor to vary the prevalence of MC (i.e. clinical exam, biology, electrocardiogram), with the highest values for autopsy series, until 24% of patients. It does not exist therefore of gold standard for the diagnosis of MC in clinical practice leading to a modest knowledge of this nosological entity. In clinical practice, troponin plasma level determines the diagnostic.
Otherwise, the measurement of myocardial strain (2D-strain) by transthoracic echocardiography (TTE) is a robust tool to assess the myocardial function. This ultrasound analysis allows an objective and topographical quantification of an acute myocardial dysfunction, be it global or segmental. 2D-strain has been thus has been validated for the diagnosis of myocardial dysfunction in medical setting. Its use in trauma setting has never been reported.
Study Design
Outcome Measures
Primary Outcome Measures
- Occurrence of an a segmental or global acute myocardial dysfunction [In the first week following trauma]
Using transthoracic echocardiography to assess the myocardial function
Eligibility Criteria
Criteria
Inclusion Criteria:
-
severe trauma patients with blunt chest trauma
-
(AIS Thorax score ≥ 1)
-
admitted in our trauma intensive care unit
-
and included within the 24 first hours following trauma
Exclusion Criteria:
-
Imminent death
-
Recovered cardiocirculatory arrest following trauma
-
Critical patient : AIS score ≥5 on 1 lesion, requiring ECLS (extracorporeal life support) or REBOA (resuscitative endovascular balloon occlusion of the aorta)
-
Refractory hypovolaemia
-
Arrhythmia, atrial fibrillation
-
Congenital heart disease, ischemic cardiomyopathy, moderate or severe pre-existing valvular heart disease, pulmonary arterial hypertension (PAH)
-
Valve prosthesis or pacemaker
-
Insufficient quality of ultrasound image to allow correct assessment of 2D-strain
-
Pregnant woman and underage patients
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Uhmontpellier | Montpellier | Montepllier | France | 34295 |
Sponsors and Collaborators
- University Hospital, Montpellier
- Assistance Publique Hopitaux De Marseille
Investigators
- Principal Investigator: Jonathan CHARBIT, MD, University Hospital, Montpellier
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- RECHMPL20_0380