Respiratory Variation of Superior Vena Cava in Transthoracic View as a Fluid Responsiveness Predictor

NCT05211765 | Unknown

• 1 other identifier: 78/20
• Study Type: observational
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Fluid evaluation is relevant in critical care. Cardiac ultrasound is the first line of evaluation in hemodynamic characterization of patients in shock, to tailor therapy. Fluid responsiveness predictors allow to better decide when to administer fluids, and transesophagic view of superior vena cava is an effective one. Recently a transthoracic view of the superior vena cava has been described. The investigators aim to evaluate if the variations of superior vena cava can predict fluid responsiveness in critically il, ventilated patients. Hypothesis: Respiratory variations of superior vena cava diameter, evaluated with transthoracic ultrasound, can predict fluid responsiveness

Conditions

Shock

Outcome Measures

Primary Outcomes (1)

• Fluid responsiveness

  An increase of 10% or more in the left ventricle velocity time integral value (average of 3 in regular rhythms or 5 in irregular rhythms) measured with cardiac ultrasound in 5 chambers apical view after the infusion of 100ml bolus of intravenous crystalloid solution.

  1 minute

Interventions

Superior vena cava transthoracic evaluation DIAGNOSTIC_TEST

The superior vena cava will be observed with a cardiac ultrasound machine, its diameter in different respiratory phases evaluated and compared with fluid response.

Eligibility Criteria

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

Study Population

Ventilated critically ill patients with hemodynamic instability hospitalized in the intensive care unit.

You may qualify if:

• Patients \>18 years,
• Hospitalized in the Intensive Care Unit (ICU) with length of stay under 7 days
• Under positive pressure ventilation with no inspiratory effort,
• With hemodynamic instability (defined as abnormal peripheral perfusion or increased blood lactic or vasopressor infusion of norepinephrine \>0.1 ug/kg/min to achieve adequate mean arterial pressure)

You may not qualify if:

• Spontaneous ventilatory effort
• Lack of venous access
• Carrier of carbapenemase or clostridium difficile
• Lack of adequate superior vena cava (SVC) window (not allowing M-mode during both respiratory phases)
• Severe aortic regurgitation
• Impossibility to measure LVOT-VTI
• Extracorporeal membrane oxygenation.

Sponsors & Collaborators

• University of Chile: lead

Study Sites (1)

Hospital Clínico Universidad de Chile

Santiago, Santiago Metropolitan, 8380420, Chile

RECRUITING

Related Publications (22)

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• Ugalde D, Haruel PA, Godement M, Prigent A, Vieillard-Baron A. Transthoracic echocardiography to evaluate the superior vena cava in critically ill patients: window description and pilot study. Intensive Care Med. 2019 Jul;45(7):1052-1054. doi: 10.1007/s00134-019-05621-1. Epub 2019 Apr 25. No abstract available.

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• Ugalde D, Montoya J, Medel JN, Eisen D, Vieillard-Baron A. Diagnostic accuracy of superior vena cava variability by transthoracic echocardiography as a fluid responsiveness predictor in critically ill patients. J Crit Care. 2026 Apr;92:155420. doi: 10.1016/j.jcrc.2025.155420. Epub 2025 Dec 23.

  PMID: 41443025 DERIVED

MeSH Terms

Conditions

Shock

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Diego Ugalde, MD

CONTACT

+56974197896; diegougaldecastillo@gmail.com

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Study Record Dates

• First Submitted: December 28, 2021
• First Posted: January 27, 2022
• Study Start: March 7, 2021
• Primary Completion: November 1, 2023
• Study Completion: March 1, 2024
• Last Updated: November 29, 2023

Record last verified: 2023-11

Locations

CL (1)