Inferior Vena Cava Indexes in Positive Pressure Supports

Study Overview
=================
Brief Summary
-----------------
Collapsibility (CI-IVC), distensibility (dIVC) and delta (ΔIVC) indices, which are dynamic measures of inferior vena cava (IVC) diameter, are used to assess the intravascular volume status in critically ill patients. Positive pressure support (PS) has been shown to induce IVC diameter distention by increasing intrathoracic pressure, and high positive expiratory pressure (PEEP) decreases the CI-IVC percentage (4). During Triggered positive pressure support it is necessary to clarify which IVC index is valid for measuring the volume status.it is aimed to compare the IVC indexes (CI-IVC, DIVC, ΔIVC), positive rate of change with pressure, correlation with central venous pressure and accurate prediction of volume status in patients with different positive pressure support.

Detailed Description
-----------------
The IVC diameters at different pressure supports were measured by the same clinician after obtaining a clear image of where the US and IVC measurements were made and the probe stabilization was achieved. He performed the procedure of changing the pressure supports, a blind independent intensive care physician without working, and recorded the applied pressure supports respectively. The different pressure supports applied are as follows: PS 10 mmHg-PEEP 5 mmHg, PS 0 mmHg- PEEP 5 mmHg PS 10 mmHg- PEEP 0 mmHg. T-tube (PS 0 mmHg-PEEP 0 mmHg)

Official Title
-----------------
Inferior Vena Cava Indexes (Collapsibility, Distensibility, Delta) in Positive Pressure Supports and Prediction Ability of Intravascular Volume Status in ICU Patients

Conditions
-----------------
Positive-Pressure Respirations, Respiratory Failure

Intervention / Treatment
-----------------
* Other: IVC diametres


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age>18 years Current use of mechanical ventilation through an endotracheal tube. Exclusion Criteria: Profound Hypoxia defined as a fraction of inspired oxygen requirement >90% or a PEEP >10 mmHg Patient-ventilator desynchrony or active agitation Unstable O2 requirement Cardiovascular instability Current PEEP requirements of >10 mmHg Current oxygen saturation (SpO2) of <88%. High intra abdominal pressure Right cardiac failure Morbid obesity

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PS 10 mmHg, PEEP 5 mmHg<br>IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index | Other: IVC diametres<br> <br> * Other names: Positive pressure supports;|
| PS 10 mmHg PEEP 0 mmHg<br>IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index | Other: IVC diametres<br> <br> * Other names: Positive pressure supports;|
| PS 0 mmHg PEEP 5 mmHg<br>IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index | Other: IVC diametres<br> <br> * Other names: Positive pressure supports;|
| t tube (PS 0 mmHg PEEP 0mmHg)<br>IVC diametres, CI-IVC, distensibility and delta index measurements using by ultrasound. Central venous pressure correlation with IVC index | Other: IVC diametres<br> <br> * Other names: Positive pressure supports;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine the effect of positive pressure on IVC collapsibility index | Determine the effect on CI-IVC of an increase in positive end-expiratory pressure and pressure support | 12 month | 
| Determine the effect of positive pressure on IVC distensibility index | Determine the effect on distensibility index of an increase in positive end-expiratory pressure and pressure support | 12 month | 
| Determine the effect of positive pressure on IVC delta index | Determine the effect on delta index of an increase in positive end-expiratory pressure and pressure support | 12 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine the effect of positive pressure on central venous pressure | Determine the effect on central venous pressure of an increase in positive end-expiratory pressure and pressure support | 12 month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Ultrasound,inferior vena cava, positive pressure