End-expiratory Occlusion Test and Prediction of Preload Dependence
Study Details
Study Description
Brief Summary
Three sets of measurements of hemodynamic parameters and sub-aortic VTI were performed:
before and at the end of 15 seconds end-expiratory occlusion and after 250 mL saline administration over 10 minutes. Patients were considered responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. SPSS was used for statistic study. A p < 0.05 was considered significant. The investigators performed univariate and then multivariate analysis.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
The patients included were in the supine position in a prone position at 30°. They had continuous monitoring by: electrocardioscopy; pulse oximetry and invasive blood pressure. Diuresis was monitored hourly.
A venous access to the superior vena cava territory (central venous catheter) was set up.
The patients were sedated with a Ramsay score > 4 and ventilated in controlled assisted mode.
The sub-aortic TVI (in cm) was measured in an apical 5-chamber section by pulsed Doppler using a 1-5 MHz ultrasound probe (M-Turbo sonosite). Three sets of measurements of hemodynamic parameters and sub-aortic VTI were performed: before and at the end of 15 seconds end-expiratory occlusion and after 250 mL saline administration over 10 minutes. At each point, the investigators noted the hemodynamic, ultrasound and biological parameters.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Responders to fluid challenge Responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. |
Diagnostic Test: End-expiratory occlusion test
15 seconds end-expiratory occlusion
|
| Non responders to fluid challenge Non responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. |
Diagnostic Test: End-expiratory occlusion test
15 seconds end-expiratory occlusion
|
Outcome Measures
Primary Outcome Measures
- an increase in sub-aortic VTI of more than 10% [before and 10 minutes after 250 mL saline administration]
the variation of sub aortic VTI by cardiac ultrasonography
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients under mechanical ventilation and sedation in the intensive care units
-
patients for whom the decision of 250 mL saline administration was taken for : hypotension (systolic pression under 90 mmHg or diatolic pression under 40 mmHg or tachycardia more than 90 pulse per minute or oliguria or the increase in cathecholamin needs.
Exclusion Criteria:
-
Pulmonary Edema
-
arrythmia
-
dialysis
-
Prone position
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Mongi Slim hospital | Tunis | Tunisia | 2085 |
Sponsors and Collaborators
- Mongi Slim Hospital
Investigators
- Principal Investigator: Mhamed Sami MS Mebazaa, Pr, Mongi Slim Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- TOTE Rea