End-expiratory Occlusion Test and Prediction of Preload Dependence

Mongi Slim Hospital

Status: Completed

Conditions: Intensive Care Units; Blood Volume; Ultrasonography

Treatments: Diagnostic Test: End-expiratory occlusion test

Study type: Observational

Funder types: Other

Identifiers

NCT05874531

TOTE Rea

Details and patient eligibility

About

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.

Full 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.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

60 participants in 2 patient groups

Responders to fluid challenge

Description:

Responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion.

Treatment:

Diagnostic Test: End-expiratory occlusion test

Non responders to fluid challenge

Description:

Non responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion.

Treatment:

Diagnostic Test: End-expiratory occlusion test