Fluid Responsiveness Evaluation by AbdomiNal Compression in Kids Based on the STARLING Concept

NCT ID: NCT02505646

Last Updated: 2016-12-28

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

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-07-31

Study Completion Date

2016-12-31

Brief Summary

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Purpose:

Fluid responsiveness in a context of circulatory failure can be predicted by different way. Dynamic criteria such as pulse pressure variation, stroke volume variation during an end-expiratory occlusion maneuver or a passive leg raising have been reported to predict fluid responsiveness. Only aortic velocity peak variation measured with transthoracic echocardiography during mechanical ventilation has been reported to predict fluid responsiveness in children. Besides some physician use a maneuver of abdominal compression to predict fluid responsiveness in children with circulatory failure. This strategy has never been formally evaluated.

The investigators will study the diagnosis accuracy of the stroke volume variation induced by an abdominal compression to predict stroke volume variation after 10 ml/kg fluid load in children with circulatory failure.

Thirty-eight pediatric patients under eight years old in circulatory failure, for whom the attending physician has decided a fluid load will be included. Hemodynamic parameters: arterial pressure, heart rate, stroke volume measured with echocardiography; will be recorded. This data collection will be performed before, after abdominal compression and after a fluid load of 10 ml/kg.

Patients will be aposteriori sorted in two groups: Fluid responders and Fluid non-responders. Fluid responders are defined as patients that show an increase greater than 15 % in stroke volume. The diagnosis ability of the Stroke volume variation after an abdominal compression to predict fluid responsiveness will be investigate and receiving operative characteristic (ROC) curve will be built. The correlation between the variation of stroke volume during abdominal compression and during the fluid load will be studied. Other parameters such as arterial pressure and heart rate will also be investigated.

Detailed Description

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Conditions

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Circulatory Failure

Keywords

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circulatory failure fluid responsiveness abdominal compression

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Observational study. No special intervention will be made

Data will be recorded in a context of fluid load in a context of circulatory failure. Stroke volume will be monitored, before, after an abdominal compression and after a fluid load.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age \< 8 years old
* Patient with a circulatory failure defined as follow :

Treatment including vasopressor or inotrope

OR macrocirculatory failure

* Heart rate \> 2 Standard Deviation (SD)
* Systolic arterial pressure \< 2 SD
* Mean arterial pressure \< 2 SD
* Diastolic arterial pressure \< 2 SD

WITH signs of microcirculatory failure

* Capillary refill time \> 2 secondes
* Blotch
* Organ dysfunction due to the circulatory failure (Oliguria \< 0,5 ml/kg/h, acute lung injury, encephalopathy)

Exclusion Criteria

* Opposition from the parents or the one who holds the parental authority
* Cardiogenic acute pulmonary edema,
* Extreme hemodynamic instability,
* Intra-abdominal hypertension,
* Recent abdominal surgery that does not permit an abdominal compression without causing pain.
* Patient with mechanical circulatory support, such as Extra Corporal Life Support or Berlin-Heart
* Patient with congenital cardiopathy with a palliative correction or an incomplete correction
* Open thorax
* Prone position
* Investigators not available
* No security number registration.
* Moribund patient
Maximum Eligible Age

8 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hopital Louis Pradel

OTHER

Sponsor Role lead

Responsible Party

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Matthias Jacquet-Lagrèze

Dr Matthias Jacquet-Lagèze

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jean-Luc Fellahi, MD, PhD

Role: STUDY_DIRECTOR

Hôpital Louis Pradel, Hospice Civil de Lyon

Locations

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Intensive care and anesthesiology department, Hôpital Louis Pradel.

Lyon, , France

Site Status

Pediatric Intensive care, Hôpital Femme Mère Enfant

Lyon, , France

Site Status

Countries

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France

References

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Jacquet-Lagreze M, Tiberghien N, Evain JN, Hanna N, Courtil-Teyssedre S, Lilot M, Baudin F, Chardonnal L, Bompard D, Koffel C, Portefaix A, Javouhey E, Fellahi JL. Diagnostic accuracy of a calibrated abdominal compression to predict fluid responsiveness in children. Br J Anaesth. 2018 Dec;121(6):1323-1331. doi: 10.1016/j.bja.2018.06.030. Epub 2018 Sep 6.

Reference Type DERIVED
PMID: 30442260 (View on PubMed)

Other Identifiers

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EudraCT/ANSM 2015-A00388-41

Identifier Type: -

Identifier Source: org_study_id