Respiratory Variation in Central Venous Oxygen Saturation Predicts Volume Responsiveness in Hemodynamically Unstable Patients Under Mechanical Ventilation : a Prospective Cohort Study

NCT ID: NCT02142985

Last Updated: 2021-05-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2015-10-31

Brief Summary

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Vascular filling is the main treatment of hypovolemia. Hypovolemia diagnosis can be difficult in some situations and need to be confirmed with other investigations.

Venous oxymetry based on the ScvO2 values represent a valuable way to predict responsivness to fluid filling maneuver in patients with hemodynamic instability.

Detailed Description

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Vascular filling represent the milestone of the treatment of hypovolemia. Its main objective is to restore vascular volume and correct perfusion issues preventing the deleterious consequences of prolonged shock.

Hypovolemia diagnosis is easy to made in obvious clinical situations such as hemorrhagic shock, deshydratation..., but there still many diagnostic difficulties regarding latent hypovolemia especially if associated with left ventricular dysfunction.

In this situations, diagnostic of hypovolemia is hard to made and other investigations are needed.

Central venous pressure (CVP) and pulmonary occlusion artery pressure (PAPO) are the mainly used parameters for indicating vascular filling but actually many studies underline their low liability in this situation.

After vascular filling, outcome measurment is needed to evaluate the efficacity of the treatment.

Outcome measurment based on hemodynamic criteria is still insufficient. In fact, tissue hypoxia persists if the cardio - respiratory system did not adapt to the metabolic needs, that's why a pathway based on therapeutic objectives like venous oxymetry is needed.

Theorically, a filling maneuver is beneficial if associated with a ScvO2 amelioration. It reflects the amelioration of cardiac output and predicts the positive responsivness to the filling test.

Conditions

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Hemodynamic Instability

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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crystalloid solution

vascular filling with 500 ml of crystalloid solution within 10 minutes

Group Type EXPERIMENTAL

Sodium Chloride 0.9% Intravenous

Intervention Type DRUG

vascular filling with 500 ml of crystalloid solution (sodium chloride 0.9%) over 30 minutes

Interventions

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Sodium Chloride 0.9% Intravenous

vascular filling with 500 ml of crystalloid solution (sodium chloride 0.9%) over 30 minutes

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* patients aged above 18 year old
* hemodynamic instability (hypotension or shock)

Exclusion Criteria

* intra cardiac shunt
* severe arrythmia
* valvular regurgitation
* pacemaker
* pulmonary oedema
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Monastir

OTHER

Sponsor Role lead

Responsible Party

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Pr. Semir Nouira

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nouira Samir, Professor

Role: STUDY_DIRECTOR

Research Laboratory (LR12SP18) University of Monastir 5000 Tunisia

Locations

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Emergency department of university hospital Fattouma Bourguiba of Monastir

Monastir, , Tunisia

Site Status

Countries

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Tunisia

References

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Khalil MH, Sekma A, Zhani W, Zorgati A, Ben Soltane H, Nouira S; GREAT Network. Variation in central venous oxygen saturation to assess volume responsiveness in hemodynamically unstable patients under mechanical ventilation: a prospective cohort study. Crit Care. 2021 Jul 13;25(1):245. doi: 10.1186/s13054-021-03683-6. No abstract available.

Reference Type DERIVED
PMID: 34256822 (View on PubMed)

Related Links

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Other Identifiers

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ScvO2 Flo-Trac study

Identifier Type: -

Identifier Source: org_study_id

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