Inferior Vena Cava Collapsibility and Distensibility Assessment in Critical Care.
NCT Number: NCT06516692
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Sepsis|Acute Renal Failure|Acute Gastroenteritis|Diabetic Ketoacidosis
Interventions: DIAGNOSTIC_TEST: Inferior Vena Cava Collapsibility/distensibility Index (IVC CI/DI) assessment
Sponsor: Jinnah Postgraduate Medical Centre
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 180
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: DIAGNOSTIC
Start Date: 2024-08-01
Completion Date: 2024-10
Locations: Jinnah Post graduate Medical Centre, Karachi, Sindh, 71550, Pakistan

Summary:
This study will help in determining the impact of assessment of Inferior Vena Cava Collapsibility and Distensibility Index (IVC CI and DI) through Point Of Care Ultra Sound (POCUS), for the fluid management of critically ill patients. This would help in better management of such patients in resource limited countries, where costly equipment for cardiac output monitoring and fluid management are frequently not available.

Moreover this study will help in development of future guidelines for fluid resuscitation in critically ill patients.

Primary Outcome Measures: Within 24-hours, 7-day and 28 day mortalities, Death of participant will be considered mortality., Mortalities will be assessed and recorded within 24hour, then day 7 up to 28th day.|Cumulative fluid balance, A difference of total amount of fluids given both intravenously and through oral rout to a total amount of urine output or fluid removed during dialysis, calculated in milliliter (ml) will be taken as cumulative fluid balance., At 6 hours of enrolment of participant|Change in Sequential Organ Failure Assessment score(Δ SOFA), A difference will be noted in initial Sequential Organ Failure Assessment score ( from 0 up to 24) to score at 24 hours .A positive difference in score will be considered as improvement and a negative difference will be considered as worsening in outcomes. Values for cumulative SOFA scores as well as individual organ SOFA scores for hepatic, neurological, cardiovascular, renal, coagulopathy and respiratory will be analyzed., At 24 hours of enrolment
Secondary Outcome Measures: Days in Intensive Care Unit (ICU), Total ICU stay in days will be noted, ICU days up to 28 day|Days on mechanical ventilation, This outcome will be measured for the participants who will be mechanically ventilated., Days in which participant will be on mechanical ventilation up to 28 days|Change in lactic acid levels in septic patient, This outcome will be measured as difference of values from the time of enrolment to 6 hours in mmol/L in patients with diagnosis of sepsis in the trial, At 6 hours of enrolment of participant|Change in Blood Sugar random (BSR) levels in patients with diabetic ketoacidosis, This outcome will be measured in mg/dL in patients with diagnosis of diabetic ketoacidosis in the trial, At 6 hours of enrolment of participant|Change in Power of hydrogen (PH) in patients with sepsis and diabetic ketoacidosis, This outcome will be calculated as difference of values from time of enrolment to 6 hours., At 6 hours of enrolment of participant