IVC Variation After VT Challenge to Predict Fluid Responsiveness

Fudan University

Status

Unknown

Conditions

Cardiac Surgery

Mechanical Ventilation

Fluid Challenge

Fluid Responsiveness

Study type

Observational

Funder types

Other

Identifiers

NCT03397784

VIVC-TVC

Details and patient eligibility

About

The purpose of the study was to evaluate the efficacy of using the respiratory variation in inferior vena cava diameters as an index of fluid responsiveness after tidal volume challenge in mechanically ventilated patients after cardiac surgery.

Full description

The "tidal volume challenge" is a novel test to predict fluid responsiveness in patents in shock, ventilated using low tidal volume without spontaneous breathing activity. The test involves transiently increasing tidal volume from 8 ml/kg PBW to 12 ml/kg PBW for one minute and observing the change in PPV or SVV. The aim of this study was to evaluate whether the respiratory variation in inferior vena cava diameter after tidal volume challenge can predict fluid responsiveness in cardiac surgical patients with mechanical ventilation

Enrollment

70 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

acute circulatory failure (low blood pressure or urine output, tachycardia, or mottling)
clinical signs of organ hypoperfusion (renal dysfunction or hyperlactatemia)

Exclusion criteria

a contraindication to elevation of tidal volume
evidence of cardiac arrhythmia
left ventricular ejection fraction less than 50%
echocardiographic examination that showed the existence of severe tricuspid or mitral regurgitation or right heart dysfunction
intracardiac shunt
pulmonary hypertension
severe chronic obstructive pulmonary disease
a contraindication to the passive leg raising (PLR) test
air leakage through chest drains
abdominal compartment syndrome
portal hypertension
pregnancy
inability to perform ultrasonography