Changes in PPV Induced by PLR Test to Predict Fluid Responsiveness in ICU
NCT ID: NCT03225378
Last Updated: 2021-10-27
Study Results
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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COMPLETED
286 participants
OBSERVATIONAL
2017-09-21
2021-09-20
Brief Summary
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In clinical practice, cardiac output measurement can be difficult for different reasons such as the unavailability of the echocardiography machine, or the absence of any continuous cardiac output monitoring technique at the time of acute circulatory failure occurrence.
Recently, it was shown that the decrease in pulse pressure variation (PPV) induced by the mini-fluid challenge (100 mL of colloid solution infused in 1 min) was able to predict fluid responsiveness with reliability in patients ventilated with low tidal volume (\<8 mL/kg of ideal body weight).
Therefore, the investigators hypothesize that the changes in PPV induced by PLR test could be able to predict fluid responsiveness with reliability in mechanically ventilated patients with acute circulatory failure.
Detailed Description
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Conditions
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Keywords
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Acute circulatory failure
Mechanically ventilated patients displaying acute circulatory failure in whom the physician decides to perform a fluid challenge (fluid loading of 500 mL of crystalloid solution) and a passive leg raising test to predict fluid responsiveness.
Fluid loading of 500 mL of crystalloid solution
Infusion of 500 mL of crystalloid solution in less than 15 minutes
Passive Leg Raising test
This intervention is done before the fluid loading in order to predict fluid responsiveness.
Interventions
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Fluid loading of 500 mL of crystalloid solution
Infusion of 500 mL of crystalloid solution in less than 15 minutes
Passive Leg Raising test
This intervention is done before the fluid loading in order to predict fluid responsiveness.
Eligibility Criteria
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Inclusion Criteria
* Patients in whom the physician decides to perform a fluid challenge based on the presence of one of the following criteria:
(1) systolic arterial pressure \<90 mmHg, mean arterial pressure \<65 mmHg, or the need for vasopressor infusion; (2) skin mottling; (3) urine output \<0.5 mL/Kg/h for more than or equal to 2 hours; (4) lactate concentrations \> 2 mmol/L
* Patients in whom the physician decides to perform a PLR test to predict fluid responsiveness
* Arterial catheter should be in place for invasive monitoring of arterial pressure and PPV
* Age \<18 yrs
* Pregnancy
* Moribund patients
* Risk of fluid loading induced pulmonary edema
* Cardiac arrhythmias
* Contraindication to perform PLR (intracranial hypertension, pelvic fractures)
Exclusion Criteria
* Changes in ventilatory parameters during the protocol
18 Years
ALL
No
Sponsors
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Centre Hospitalier Arras
OTHER
Responsible Party
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Principal Investigators
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Jihad MALLAT, MD
Role: PRINCIPAL_INVESTIGATOR
Centre Hospitalier Arras
Locations
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CHU d'Amiens - Réanimation Cardio-Thoracique-Vasculaire
Amiens, , France
CHU d'Amiens - Réanimation chirurgicale
Amiens, , France
Centre Hospitalier d'Arras
Arras, , France
Centre Hospitalier de Béthune
Béthune, , France
CH Boulogne-sur-mer
Boulogne-sur-Mer, , France
CHU de Caen
Caen, , France
Centre Hospitalier de Cambrai
Cambrai, , France
CHU de Dijon
Dijon, , France
Centre Hospitalier de Lens - Anesthésie-Réanimation
Lens, , France
Centre Hospitalier de Lens - Réanimation
Lens, , France
CHRU de Lille - Réanimation Médicale
Lille, , France
CHU de Rouen
Rouen, , France
Countries
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References
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Monnet X, Marik P, Teboul JL. Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis. Intensive Care Med. 2016 Dec;42(12):1935-1947. doi: 10.1007/s00134-015-4134-1. Epub 2016 Jan 29.
Cherpanath TG, Hirsch A, Geerts BF, Lagrand WK, Leeflang MM, Schultz MJ, Groeneveld AB. Predicting Fluid Responsiveness by Passive Leg Raising: A Systematic Review and Meta-Analysis of 23 Clinical Trials. Crit Care Med. 2016 May;44(5):981-91. doi: 10.1097/CCM.0000000000001556.
Mallat J, Meddour M, Durville E, Lemyze M, Pepy F, Temime J, Vangrunderbeeck N, Tronchon L, Thevenin D, Tavernier B. Decrease in pulse pressure and stroke volume variations after mini-fluid challenge accurately predicts fluid responsivenessdagger. Br J Anaesth. 2015 Sep;115(3):449-56. doi: 10.1093/bja/aev222. Epub 2015 Jul 6.
Mallat J, Abou-Arab O, Lemyze M, Saleh D, Guinot PG, Fischer MO. Changes in central venous-to-arterial PCO2 difference and central venous oxygen saturation as markers to define fluid responsiveness in critically ill patients: a pot-hoc analysis of a multi-center prospective study. Crit Care. 2024 Nov 8;28(1):360. doi: 10.1186/s13054-024-05156-y.
Mallat J, Lemyze M, Fischer MO. Passive leg raising test induced changes in plethysmographic variability index to assess fluid responsiveness in critically ill mechanically ventilated patients with acute circulatory failure. J Crit Care. 2024 Feb;79:154449. doi: 10.1016/j.jcrc.2023.154449. Epub 2023 Oct 17.
Mallat J, Fischer MO, Granier M, Vinsonneau C, Jonard M, Mahjoub Y, Baghdadi FA, Preau S, Poher F, Rebet O, Bouhemad B, Lemyze M, Marzouk M, Besnier E, Hamed F, Rahman N, Abou-Arab O, Guinot PG. Passive leg raising-induced changes in pulse pressure variation to assess fluid responsiveness in mechanically ventilated patients: a multicentre prospective observational study. Br J Anaesth. 2022 Sep;129(3):308-316. doi: 10.1016/j.bja.2022.04.031. Epub 2022 Jul 14.
Other Identifiers
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2017_01
Identifier Type: -
Identifier Source: org_study_id