Timing of Preload Responsiveness in Sepsis

Study Overview
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Brief Summary
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During acute circulatory failure, volume expansion does not always lead to a significant increase in cardiac output (fluid responsiveness). After initial resuscitation by rapid fluid administration, cardiac preload is no longer extremely low and only half of the patients respond to further volume expansion with the expected increase in cardiac output (fluid unresponsiveness). However, the time delay or the volume of fluid needed to be administered from the state of fluid responsiveness to fluid unresponsiveness is still not determined. Objective To determine, in critically ill patients with acute circulatory failure, : the time and/or the volume of fluid needed from the state of fluid responsiveness to fluid unresponsiveness during septic shock. : determine the factors that influence this time and volume.

Official Title
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Timing of Preload Responsiveness in Sepsis and Septic Shock

Conditions
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Septic Shock, Fluid Responsiveness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 ans Onset of septic shock Exclusion Criteria: Planned to transfer the patient to another healthcare facility (inability to continue cardiac output measurements); urgent operation; Inability to measure the cardiac output.

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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The time delay from the state of fluid responsiveness to fluid unresponsiveness | At the time of inclusion, the investigators use the tests available (fluid challenge, passive leg raising, end-expiratory occlusion test) to evaluate the presence of fluid responsiveness, and after one hour, the investigators repeat the test and to re-evaluate the presence of fluid responsiveness until the patient is no longer present the fluid responsiveness. | 60 minutes after the evaluation of fluid responsiveness | 
| The volume of fluid needed from the state of fluid responsiveness to fluid unresponsiveness | If the fluid challenge is performed, the volume of each time for the fluid administration should be noted until the patient is no longer fluid-responsive, then the investigators can calculate the total amount of the fluid administrated. | 15-30 minutes during the fluid administration | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The risk factors for the time delay | Determine the factors that may influence the time delay from the state of fluid responsiveness to fluid unresponsiveness | Through study completion, an average of 1 year | 
| The risk factors for the volume of fluid needed from the state of fluid responsiveness to fluid | Determine the factors that may influence the volume of fluid administrated from the state of fluid responsiveness to fluid unresponsiveness | Through study completion, an average of 1 year |