Clinical trial NCT03452046: Inferior Vena Cava Indexes in Positive Pressure Supports
Official title: Inferior Vena Cava Indexes (Collapsibility, Distensibility, Delta) in Positive Pressure Supports and Prediction Ability of Intravascular Volume Status in ICU Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Positive-Pressure Respirations
Respiratory Failure
Keywords: Ultrasound,inferior vena cava, positive pressure
Lead sponsor: Tepecik Training and Research Hospital
Sponsor class: OTHER
First posted: 2018-03-02
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Inpatient sample

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:

1. PS 10 mmHg-PEEP 5 mmHg,
2. PS 0 mmHg- PEEP 5 mmHg
3. PS 10 mmHg- PEEP 0 mmHg.
4. T-tube (PS 0 mmHg-PEEP 0 mmHg)

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

Primary outcomes:
measure: Determine the effect of positive pressure on IVC collapsibility index
timeFrame: 12 month
measure: Determine the effect of positive pressure on IVC distensibility index
timeFrame: 12 month
measure: Determine the effect of positive pressure on IVC delta index
timeFrame: 12 month
Secondary outcomes:
measure: Determine the effect of positive pressure on central venous pressure
timeFrame: 12 month
Other outcomes:
Locations:
city: Izmir
country: Turkey
facility: Tepecik Research and Training Hospital
state: Konak
Study officials:
affiliation: Tepecik Training and Research Hospital
name: Tepecik Training and Research Hospital
role: PRINCIPAL_INVESTIGATOR
References: