Fluid Challenge Impact in the Portal Vein Pulsatility Depending on the Fluid Responsivness Status (FLUID-REVENGE)

Civil Hospices of Lyon

Status: Completed

Conditions: Cardiovascular Insufficiency; Venous Congestion

Study type: Observational

Funder types: Other

Identifiers

NCT05828407

2023-A00196-39 (Other Identifier)

69HCL22_1115

Details and patient eligibility

About

Portal vein pulsatility index is a marker of venous congestion evaluated by point of care ultrasound. It is associated with acute kidney injury, especially in critically ill patients. It may be considered as a dynamic marker. The investigators hypothesized that portal vein pulsatility index is higher after a fluid challenge only in patient without preload dependence in critically ill patients with cardiovascular insufficiency.

Enrollment: 36 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• vasopressor requirement to maintain mean arterial pressure >65mmHg AND

• at least one of the following criteria:

  • arterial lactate >2mmol/L;
  • capillary refill time >3s;
  • mottling score >1;
  • diuresis <0,5mL/h for more than 6hours.

Exclusion criteria

• Diameter of vena cava <20mm
• Cirrhosis
• Pregnancy
• Severe acute pulmonary edema
• Phototype 4 or 5
• Patient opposition to participate

Trial design

36 participants in 1 patient group

Cohort

Description:

Population: Critically ill patient with: * cardio circulatory insufficiency as defined by vasopressor requirement and at least one of the following criteria: arterial lactate \>2mmol/L ; capillary refill time \>3s ; mottling score \>1 ; diuresis \<0,5mL/h for more than 6hours * diameter of inferior vena cava \>20mm Protocol: Administration of a fluid challenge (4mL/kg of Ringer Lactate) over 5 to 10 min. Point of care ultrasound evaluation of portal vein pulsatility index and Vexus criteria before and after the fluid challenge ; fluid challenge induced cardiac index variations estimated by pulse contour analysis