Hemodynamic Variations During Remote Ischemic Conditioning in Critical Ill Patients (HERICA)

Lithuanian University of Health Sciences

Status: Enrolling

Conditions: Critical Illness

Treatments: Procedure: Remote ischemic conditioning

Study type: Interventional

Funder types: Other

Identifiers

NCT06536231

1.2

Details and patient eligibility

About

The main objectives of this study are to evaluate the changes in hemodynamics occurring during the remote ischemic conditioning (RIC) procedure and to compare the hemodynamic responses elicited by passive leg raising before and after the RIC intervention.

Full description

The investigators hypothesized that the inflation of the blood pressure cuff during the remote ischemic conditioning (RIC) procedure would lead to an increase in stroke volume (SV), cardiac index (CI), and peripheral perfusion index and that these changes would correlate with the hemodynamic changes induced by passive leg raising (PLR).

Furthermore, the clinical relevance of the RIC effect in critically ill patients, particularly in terms of determining their hemodynamic responsiveness, remains uncertain. The investigators hypothesized that the RIC procedure influences hemodynamic changes during PLR.

Enrollment: 50 estimated patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged over 18 years,
• admitted to the intensive care unit,
• monitored with a transpulmonary thermodilution device with calibrated pulse contour analysis (Pulsion Medical Systems, Munich, Germany),
• decision by the physician in charge to perform passive leg raising.

Exclusion criteria

• pregnancy,
• advanced malignancy,
• peripheral artery disease affecting both arms,
• head trauma,
• deep vein thrombosis in the lower limbs,
• intra-abdominal hypertension, defined as an intra-abdominal pressure greater than 12 mmHg.

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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50 participants in 1 patient group

Passive leg raising and Remote ischemic conditioning

Experimental group

Description:

Supine position was followed by the passive leg raising (PLR) maneuver. After completing the PLR test, participants were placed in the supine position for 5 min. Thereafter, remote ischemic conditioning (RIC) was performed. After the RIC procedure, the patient is left in supine position for 5 minutes. Then the PLR test was repeated, after which the participants were placed in a supine position for another 5 min at rest. When the patient fluid responder, physician in charge may decide to perform a fluid infusion (500 mL of crystaloids). The PLR test can also be performed to make decision for fluid removal. This decision is triggered by a negative PLR test in the later phase of ICU treatment. If the physician has decided to administer a fluids, systemic hemodynamics and peripheral perfusion index are measured immediately after completion of the fluid infusion.

Treatment:

Procedure: Remote ischemic conditioning