Role of Echocardiography in Guiding Fluid Therapy in Shocked Patients With Impaired Cardiac Contractility in Emergency Department

NCT05488730 | Completed DMC

• 1 other identifier: Echo in fluid therapy 2022
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

fluid therapy is one of the cornerstones in the management of shock but may result in iatrogenic fluid overload .The aim of this study was to assess the role of echocardiography in guiding fluid therapy in shocked patients with impaired cardiac contractility using straight leg raising test ,Inferior vena-cava collapsability index and Doppler imaging in Emergency Department in Alexandria main university hospital.

Conditions

Shock

Outcome Measures

Primary Outcomes (1)

• LVOT VTI variability

  variability of LVOT VTI to determine fluid responsiveness

  15 minutes

Study Arms (1)

shocked patient with impaired cardiac contractility

OTHER

Diagnostic Test: passive leg raising test and fluid challenge

Interventions

passive leg raising test and fluid challenge DIAGNOSTIC_TEST

Shocked patients were subjected to echocardiographic examination if (EF \<52%) .baseline LVOT VTI was obtained Then IVC scanning was done through subcostal Window and using M-mode the minimum and the maximum diameters were measured then the collapsibility index was calculated Then passive leg raising test was done Patients who tolerated the PLR test and did not develop clinical or lung ultrasound signs of fluid overload (lung congestion) were given IV fluid bolus (250 ml normal saline) over 10 minutes followed by measurement of LVOT VTI. Patients who did not tolerate PLR test or developed clinical or lung ultrasound signs of fluid overload (lung congestion) during PLR test were excluded from the third step (fluid challenge). The differentiating factor used to allocate patient in which group (non-responder or responder) was LVOT VTI variability after fluid challenge (our gold standard to assess fluid responsiveness).

shocked patient with impaired cardiac contractility

Eligibility Criteria

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

You may qualify if:

• shocked patient with impaired cardiac contractility

You may not qualify if:

• Trauma patients.
• Patient with unstable arrhythmias.
• Patients with lower limb amputation.
• Mechanically ventilated patients.
• Patients with prosthetic aortic valve.
• Patients less than 18 years old
• Pregnant.

Sponsors & Collaborators

• Alexandria University: lead

Study Sites (1)

Faculty of Medicine

Alexandria, Egypt

Location

MeSH Terms

Conditions

Shock

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant lecturer of emergency medicine

Study Record Dates

• First Submitted: August 3, 2022
• First Posted: August 5, 2022
• Study Start: August 1, 2021
• Primary Completion: July 30, 2022
• Study Completion: August 3, 2022
• Last Updated: August 16, 2022

Record last verified: 2022-08

Locations

EG (1)