Ultrasound Markers of Systemic Inflammation

Study Overview
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Brief Summary
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The aim of this study was to measure whether the flow rate through the brachial artery and inflammatory markers were associated with the development of tissue edema in the surgical intensive care unit patients.

Detailed Description
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The study was performed using a ultrasound machine with linear probe settings at 50 mm depth and 40 decibel [dB] gain that did not change during the study. The probe was placed on vascular ultrasound measurement. The diameter of the brachial artery in the middle of the upper arm and the flow rate through the artery was measured on postoperative days 1 and 2. The presence of the edema was measured above the 3rd metacarpal bone as the distance from the skin surface to the periosteum. An average of three assessments was shown. Patient's age, body mass index (BMI), type of admission, white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were also registered.

Official Title
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Ultrasound in the Intensive Care Unit and Measurable Indicators of Systemic Inflammation

Conditions
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Inflammation Process, Endothelial Dysfunction, Vasomotor Arterial Disorder, Vascular Dilation, Swelling; Hand

Intervention / Treatment
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* Diagnostic Test: Ultrasound measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults over 18 years of age Postoperative surgical patients Signed informed consent Exclusion Criteria: Refusal to give informed consent A previous thromboembolic event of the brachial artery Acute infection of the upper extremity

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 patients<br>Adult patients admitted to the ICU. | Diagnostic Test: Ultrasound measurement<br>* Study was conducted with Mindray T7 ultrasound machine using linear probe. Vascular ultrasound mode was used with settings depth of 50 mm and gain of 40 dB during the entire study period. The diameter and flow velocity of the brachial artery and wrist edema of the fist were measured within 24 hours of admission and the following day.<br>* Other names: Mindray T7 ultrasound machine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diameter of brachial artery - 1 | Measurement of a brachial artery diameter [cm] at admission. Admission day is considered as day 1. | within 4 hours of admission. | 
| Diameter of brachial artery - 2 | measurement of a brachial artery diameter [cm] on day 2 after admission. | day 2 after admission is between 24 and 48 hours after admission. | 
| Brachial artery flow velocity - 1 | measurement of a brachial artery flow velocity [cm/s] at admission. | within 4 hours of admission to ICU. | 
| Brachial artery flow velocity - 2 | measurement of a brachial artery flow velocity [cm/s] on day 2 after admission. Day 2 is Measurement of a brachial artery flow velocity [cm/s] between 24 and 48 h after ICU admission. | day 2 after admission is between 24 and 48 hours after admission. | 
| Distance from skin to third metacarpal bone -1 | measurement of a distance from the skin to third metacarpal bone (cm) at admission. | within 4 hours of admission. | 
| Distance from skin to third metacarpal bone - 2 | measurement of a distance from the skin to third metacarpal bone (cm) on day 2 after admission. | day 2 after admission is between 24 and 48 hours after admission. | 
| White blood cell count - 1 | blood sample analysis for white blood cell count (WBC [10^9/L]) at admission. | within 4 hours of admission. | 
| White blood cell count - 2 | blood sample analysis for white blood cell count (WBC [10^9/L]) on day 2 after admission. | day 2 after admission is between 24 and 48 hours after admission. | 
| C-reactive protein - 1 | blood sample analysis for C-reactive protein (CRP [mg/L]) concentration at admission. | within 4 hours of admission. | 
| C-reactive protein - 2 | Blood sample analysis for C-reactive protein (CRP [mg/L]) concentration on day 2 after admission. | day 2 after admission is between 24 and 48 hours after admission. | 
| Procalcitonin - 1 | blood sample analysis for Procalcitonin concentration (PCT [ug/L]) at admission. | within 4 hours of admission. | 
| Procalcitonin - 2 | Blood sample analysis for Procalcitonin concentration (PCT [ug/L]) on day 2 after admission. | Day 2 after admission is between 24 and 48 hours after admission. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intensive Care, Surgical, Inflammation, Ultrasonography, Doppler