Starling Registry Study

Study Overview
=================
Brief Summary
-----------------
Hemodynamic optimization of critically ill patients is a goal for clinicians in order to afford the patient the best possible outcomes. Being able to precisely and rapidly determine patient fluid responsiveness provides the bedside physician and nursing staff the information needed to make critical decisions in regards to the patient's fluid status and management of additional fluids and medications. As fluid management and cardiac output determination are linked to better decision-making and improved outcomes in ICU, the use of a dynamic assessment of fluid responsiveness becomes a key tool for patient management. This study is designed to collect treatment and outcome data on patients that have undergone hemodynamic monitoring in a wide variety of clinical settings, involving a variety of patient diagnoses.

Official Title
-----------------
Starling Registry Study

Conditions
-----------------
Hemodynamic Monitoring

Intervention / Treatment
-----------------
* Device: Starling


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: ≥18 to 95 years of age Patient has undergone hemodynamic monitoring with the Starling monitor Hemodynamic monitoring was completed no earlier than 2018 Exclusion Criteria: None

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 95 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 |
| --- | --- |
| Improvement in Hemodynamics<br>Over the course of a patient's hospitalization, data will be collected on patients from the initiation to completion of hemodynamic monitoring with the Starling monitor in a wide variety of clinical settings, and for different diagnoses. Improvement in hemodynamics is exhibited by an increase in both Cardiac Output and Stroke Volume observed at 12 hour intervals from time of monitoring until completion. | Device: Starling<br>* Starling is a portable, non-invasive, cardiac output detector system. The Starling monitor measures the cardiac output by employing electrical bioreactance that measures the electrical characteristics of a volume of tissue and fluid. In the case of cardiac output measurements, the relevant tissue includes the heart and the immediate surrounding volume of the thorax. The relevant fluid is blood. Baxter Healthcare's Starling electrode is a double electrode sensor. Within each sensor, one electrode is used to transmit a high frequency sine wave into the body, while the resulting voltage is measured at the adjacent electrode. Four electrodes are placed at specific areas of the thorax, the impedance to the current flow calculated, and the electrical bioreactance waveform constructed. This information is used to determine cardiac output, and measures and displays associated hemodynamic parameters based on calculations of measurements already incorporated into the Starling device.<br>|
| No Improvement in Hemodynamics<br>Over the course of a patient's hospitalization, data will be collected on patients from the initiation to completion of hemodynamic monitoring with the Starling monitor in a wide variety of clinical settings, and for different diagnoses. No Improvement in hemodynamics is exhibited by no increase in both Cardiac Output and Stroke Volume observed at 12 hour intervals from time of monitoring until completion. | Device: Starling<br>* Starling is a portable, non-invasive, cardiac output detector system. The Starling monitor measures the cardiac output by employing electrical bioreactance that measures the electrical characteristics of a volume of tissue and fluid. In the case of cardiac output measurements, the relevant tissue includes the heart and the immediate surrounding volume of the thorax. The relevant fluid is blood. Baxter Healthcare's Starling electrode is a double electrode sensor. Within each sensor, one electrode is used to transmit a high frequency sine wave into the body, while the resulting voltage is measured at the adjacent electrode. Four electrodes are placed at specific areas of the thorax, the impedance to the current flow calculated, and the electrical bioreactance waveform constructed. This information is used to determine cardiac output, and measures and displays associated hemodynamic parameters based on calculations of measurements already incorporated into the Starling device.<br>|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 day in-hospital mortality rate |  | Day 1 to Day 30 | 
| Number of days on vasopressors |  | Day 1 to Day 30 | 
| Volume of treatment fluid administered |  | Time of monitoring to completion | 
| Number of participants needing mechanical ventilation |  | Time of monitoring to completion | 
| Lactate level |  | Time of monitoring to completion | 
| Number of days in Intensive Care Unit (ICU) |  | Day 1 to Day 30 | 
| Number of days in Hospital |  | Day 1 to Day 30 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with COVID-19 |  | Time of monitoring to completion | 
| Number of participants with COVID-19 by treatment type |  | Time of monitoring to completion | 
| Number of participants with COVID-19 by outcome type |  | Time of monitoring to completion | 
| Percent of participants that are fluid responsive |  | Time of monitoring to completion | 
| Number of participants with diastolic dysfunction |  | Time of monitoring to completion | 
| Percent of participants with fluid responsiveness in diastolic dysfunction |  | Time of monitoring to completion | 
| Number of participants with device related Non-Serious Adverse Events |  | Time of monitoring to completion | 
| Number of participants with device related Serious Adverse Events |  | Time of monitoring to completion | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Cardiac Index (CI), Stroke Volume (SV), Stroke Volume Index (SVI), Stroke Volume Variation (SVV), Heart Rate (HR), Ventricular Ejection Time (VET), Total Peripheral Resistance (TPR), Total Peripheral Resistance Index (TPRI), Cardiac Power (CP), Cardiac Power Index (CPI), Blood Oxygenation (SPO2), Oxygen Delivery Index (DO2I), Electrical impedance of the chest cavity (Z0), Thoracic Fluid Content (TFC)