The Use of LiDCOplus in Fluid Resuscitation Decision-Making

Study Overview
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Brief Summary
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Unwell patients in the intensive care unit (ICU) often need supplementary fluids to be given into the bloodstream through a drip in a vein (venous cannula), however too much fluid can be harmful. It can sometimes be difficult to tell whether or not a patient will benefit from extra fluids so they are given a fluid challenge, whereby a small volume of fluid is given quickly into the cannula and the change in their status is noted. If the patient's condition improves, this suggests that the patient is fluid responsive and needs more fluid. A LiDCOplus haemodynamic monitor is a device used in the ICU to estimate the amount of blood ejected from the heart on each heartbeat using pressure readings obtained from a tube placed in one of the patient's arteries (arterial line). The investigators aim to determine whether or not the use of this device called makes a difference to the judgement of fluid responsiveness when the patient is given a fluid challenge when compared to simply using measurements of pulse and blood pressure and assessing the circulation in the patient's limbs. This will allow the investigators to determine whether or not the LiDCOplus alters the decisions made by doctors and nurses about how much fluid to give their patients and hence if it is of any benefit.

Official Title
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Does the Use of LiDCOplus Alter Decision-making in Fluid Prescription During Resuscitation in the Intensive Care Unit.

Conditions
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Shock

Intervention / Treatment
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* Device: LiDCOplus haemodynamic monitor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients Admitted to Intensive Care Unit (ICU) Undergoing fluid resuscitation guided by fluid challenges Monitored by a LiDCOplus haemodynamic monitor attached to an arterial line Exclusion Criteria: Poor arterial line trace Moribund state Patient / relative refusal Contra-indication to fluid bolus

Ages Eligible for Study
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Minimum Age: 16 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 |
| --- | --- |
| Patients undergoing fluid resuscitation<br>Adult patients in the intensive care unit (ICU) undergoing fluid resuscitation guided by the LiDCOplus haemodynamic monitor. | Device: LiDCOplus haemodynamic monitor<br>* Patients in study group receive intravenous fluid bolus as part of standard fluid resuscitation. Fluid responsiveness (i.e. improvement in cardiac output) is estimated using both standard clinical parameters and by LiDCOplus haemodynamic monitor (with the clinician initially blinded to the latter) before a final decision about fluid responsiveness is made.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fluid responsiveness decisions changed by use of LiDCOplus | Proportion of decisions about fluid management changed by knowledge of the change in stroke volume post fluid challenge, as derived by LiDCOplus haemodynamic monitor. | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intensive care units, resuscitation, fluid therapy, Vascular Access Devices, cardiac output, monitoring, physiologic