Association Between SMA Flow and AGI in Critically Ill Patients

NCT04979494 | Completed

• 1 other identifier: PUMCH-JS-2687
• Study Type: observational
• Target: 69
• Locations: 1 country
• Sites: 1

Brief Summary

Acute gastrointestinal injury (AGI) is related to poor outcomes of critically ill patients \[1\] through many underlying mechanisms \[2\]. It is also a part of the process of multiple organ dysfunction syndrome (MODS). However, the morbidity of acute gastrointestinal dysfunction in critically ill patients is highly underestimated due to the scarcity of accurate measurement and thus the causes are still unclear. In this study, investigators are going to apply the technique of point-of-care ultrasound (POCUS) evaluation on the bowel diameters, wall thickness and movement combined with intra-abdominal pressure to determine the occurrence of AGI. The superior mesenteric artery (SMA) blood flow is also evaluated by POCUS to find out the association between SMA blood flow and AGI.

Conditions

Gastrointestinal Dysfunction; Critical Illness

Keywords

Regional blood flow; Gastrointestinal dysfunction; Critical care

Outcome Measures

Primary Outcomes (1)

• The occurence of acute gastrointestinal injury

  Gastrointestinal and urinary tract sonography ultrasound (GUTS) score will be calculate using a combination bowel diameter in centimeters, bowel wall thickness in centimeters, peristalsis (with or without) using ultrasound, and intra-abdominal pressure in millimeters of mercury measured through urethral tubes\[3\]. GUTS score is ranging from 0 to 4, and a higher GUTS score means worse gastrointestinal function. A GUTS score more than or equal to 2 is considered as acute gastrointestinal injury(AGI)in this study.

  Within 24 hours after the initiation of enteral feeding

Interventions

ultrasound examination OTHER

We conduct abdominal ultrasound examinations for each patient.

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients admitted into the Department of Critical Care Medicine of Peking Union Medical College Hospital, who were eligible of inclusion criteria, were included in the study.

You may qualify if:

• \~ 80 years old;
• Under deep sedation (RASS score ≤ -3) with mechanical ventilation at the time of enrollment;
• Acute Physiology and Chronic Health Evaluation II (APACHE-II) score ≥8.

You may not qualify if:

• Pregnancy;
• Recent gastrointestinal surgery;
• History of acute or chronic gastrointestinal dysfunction before ICU admission;
• Primary or secondary vascular malformation of SMA;
• Any contraindication to the use of ultrasound evaluation (e.g., abdominal incision).

Sponsors & Collaborators

• Xinchen Wang: lead

Study Sites (1)

Peking Union Medical College Hospital, Chinese Academy of Medical Science

Beijing, China

Location

Related Publications (4)

• Reintam Blaser A, Poeze M, Malbrain ML, Bjorck M, Oudemans-van Straaten HM, Starkopf J; Gastro-Intestinal Failure Trial Group. Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study. Intensive Care Med. 2013 May;39(5):899-909. doi: 10.1007/s00134-013-2831-1. Epub 2013 Jan 31.

  PMID: 23370829 BACKGROUND

• Meng M, Klingensmith NJ, Coopersmith CM. New insights into the gut as the driver of critical illness and organ failure. Curr Opin Crit Care. 2017 Apr;23(2):143-148. doi: 10.1097/MCC.0000000000000386.

  PMID: 28092310 BACKGROUND

• Perko MJ, Madsen P, Perko G, Schroeder TV, Secher NH. Mesenteric artery response to head-up tilt-induced central hypovolaemia and hypotension. Clin Physiol. 1997 Sep;17(5):487-96. doi: 10.1046/j.1365-2281.1997.05252.x.

  PMID: 9347197 BACKGROUND

• Gao T, Cheng MH, Xi FC, Chen Y, Cao C, Su T, Li WQ, Yu WK. Predictive value of transabdominal intestinal sonography in critically ill patients: a prospective observational study. Crit Care. 2019 Nov 27;23(1):378. doi: 10.1186/s13054-019-2645-9.

  PMID: 31775838 BACKGROUND

MeSH Terms

Conditions

Critical Illness

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Dawei Liu, MSc.

  Peking Union Medical College Hospital, Chinese Academy of Medical Science

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Attending Doctor

Study Record Dates

• First Submitted: May 4, 2021
• First Posted: July 28, 2021
• Study Start: September 1, 2020
• Primary Completion: September 1, 2021
• Study Completion: September 30, 2021
• Last Updated: September 4, 2024

Record last verified: 2024-08

Locations

CN (1)