End-expiratory Occlusion Test and Prediction of Preload Dependence

Study Overview
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Brief Summary
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Three sets of measurements of hemodynamic parameters and sub-aortic VTI were performed: before and at the end of 15 seconds end-expiratory occlusion and after 250 mL saline administration over 10 minutes. Patients were considered responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. SPSS was used for statistic study. A p < 0.05 was considered significant. The investigators performed univariate and then multivariate analysis.

Detailed Description
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The patients included were in the supine position in a prone position at 30°. They had continuous monitoring by: electrocardioscopy; pulse oximetry and invasive blood pressure. Diuresis was monitored hourly. A venous access to the superior vena cava territory (central venous catheter) was set up. The patients were sedated with a Ramsay score > 4 and ventilated in controlled assisted mode. The sub-aortic TVI (in cm) was measured in an apical 5-chamber section by pulsed Doppler using a 1-5 MHz ultrasound probe (M-Turbo sonosite). Three sets of measurements of hemodynamic parameters and sub-aortic VTI were performed: before and at the end of 15 seconds end-expiratory occlusion and after 250 mL saline administration over 10 minutes. At each point, the investigators noted the hemodynamic, ultrasound and biological parameters.

Official Title
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End-expiratory Occlusion Test and Prediction of Preload Dependence: Echocardiographic and Hemodynamic Study in the ICU.

Conditions
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Ultrasonography, Intensive Care Units, Blood Volume

Intervention / Treatment
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* Diagnostic Test: End-expiratory occlusion test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients under mechanical ventilation and sedation in the intensive care units patients for whom the decision of 250 mL saline administration was taken for : hypotension (systolic pression under 90 mmHg or diatolic pression under 40 mmHg or tachycardia more than 90 pulse per minute or oliguria or the increase in cathecholamin needs. Exclusion Criteria: Pulmonary Edema arrythmia dialysis Prone position

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 |
| --- | --- |
| Responders to fluid challenge<br>Responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. | Diagnostic Test: End-expiratory occlusion test<br>* 15 seconds end-expiratory occlusion<br>|
| Non responders to fluid challenge<br>Non responders to fluid loading after an increase in sub-aortic VTI of more than 10% following a volume expansion. | Diagnostic Test: End-expiratory occlusion test<br>* 15 seconds end-expiratory occlusion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| an increase in sub-aortic VTI of more than 10% | the variation of sub aortic VTI by cardiac ultrasonography | before and 10 minutes after 250 mL saline administration |