Evaluation of Three Dimensional Echocardiography in Critical Care Medicine

Study Overview
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Brief Summary
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Comparison of volumetric measurements obtained by three dimensional echocardiography with measurements obtained by thermodilution using a pulmonary artery catheter in the intensive care unit.

Detailed Description
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Prospective, observational study evaluating three dimensional echocardiography for measuring hemodynamic variables versus the current gold standard (pulmonary artery catheter). Critically ill patients with a severly compromised circulation due to a shock state with an advanced hemodynamic monitoring in place and the need for echocardiographic evaluation will be included. While performing an echocardiography study stroke volume measurements using the bolus method for thermodilution will concomittantly be measured. In case of insufficient image quality we are planning to use SonoVue echo contrast. Once the image quality has improved we will repeat the stroke volume measurements with the bolus thermodilution method while performing the echocardiography. The acquired echocardiography loops will then be analysed and measured offline once deferred consent has been obtained. We will then compare the echocardiographic measurements with the measurement obtained by the pulmonary artery catheter (bolus method) - since this is the current reference method.

Official Title
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Evaluation of Three Dimensional Echocardiography in Critical Care Medicine

Conditions
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Shock

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: advanced hemodynamic monitoring with pulmonary artery catheter and arterial catheter in place patient intubated or tracheostomy in place clinical indication for performing an echocardiography ongoing sedation requirement Exclusion Criteria: Heart rhythm other than sinus rhythm or paced atrial rhythm Known allergy to sulphur-hexafluoride (SonoVue©) Artificial heart valves in place Any form of mechanical cardiac assist contraindication to performing a transesophageal echocardiography presence of significant cardiac valve regurgitation presence of an intracardiac shunt

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ICU patient<br>Critically ill patients in our adult intensive care unit with the following characteristics: advanced hemodynamic monitoring in place including pulmonary artery catheter and arterial catheter intubated or tracheostomy in place echocardiography requested by the treating physician intervention of interest: hemodynamic assessment done by echocardiography and thermodilution (pulmonary artery catheter) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of stroke volume measurement with three dimensional echocardiography to stroke volume measurement by thermodilution | The stroke volume of three to six heart beats will be measured after having performed an echocardiographic study. The stroke volume by thermodilution will be measured during the individual examination. | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of right ventricular pressure volume loops | Off-line analysis of pressure time curve for right ventricle using data from pulmonary artery catheter and volume time curve from echocardiographic data. Assessment of feasibility to combine these two curves to a pressure volume loop. | through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Measurement of cardiac output