Peripheral Venous Analysis (PIVA) for Predicting Volume Responsiveness and Fluid Status

NCT ID: NCT03407287

Last Updated: 2021-04-12

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

TERMINATED

Total Enrollment

180 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-01-08

Study Completion Date

2020-12-01

Brief Summary

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The aim of this study is to determine the effects of fluid alternations, hemodynamic changes, mechanical ventilation, pharmacologic agents, positional changes, and comorbidities on the Peripheral Intravenous waveform Analysis (PIVA) signal.

Detailed Description

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Intravascular volume status determination remains elusive. Standard vital sign monitoring, including heart rate and blood pressure, fails to detect intravascular volume depletion and volume overload. Likewise, invasive monitoring is fraught with risk including vascular injury and central line associated infections. As such, a minimally-invasive mechanism to overcome the barriers of standard monitoring to detect volume status derangement, would be highly valuable. The goal of the study is to perform a series of observational feasibility studies in healthy and hospitalized subjects to determine effects of fluid alternations, hemodynamic changes, mechanical ventilation, pharmacologic agents, positional changes, and comorbidities on the PIVA signal

Conditions

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Systemic Inflammatory Response Syndrome Distributive Shock Hypotension and Shock Decompensated Congestive Heart Failure Atrial Fibrillation High Risk Non-cardiac Surgery

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Cardiac Catheterization

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Distributive shock

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Vasoactive and inotropic agents

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Congestive heart failure

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Atrial fibrillation

Patients with atrial fibrillation undergoing elective direct current cardioversion

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Patients undergoing surgery

Patients undergoing surgery requiring positive pressure ventilation and arterial line placement

Peripheral Intravenous Analysis (PIVA)

Intervention Type PROCEDURE

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Standard of care invasive vascular monitoring

Intervention Type PROCEDURE

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Standard noninvasive vascular monitoring

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Interventions

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Peripheral Intravenous Analysis (PIVA)

Non-invasive measurement of peripheral venous waveform analysis (PIVA) obtained by connecting a standard transducer (AD Instruments, Colorado Springs, Co) to a universal adaptor or stopcock on a peripheral IV

Intervention Type PROCEDURE

Standard of care invasive vascular monitoring

Standard of care invasive monitoring in the intensive care settings with central venous catheters, pulmonary artery catheters, or trans-esophageal echocardiography for determining volume status.

Intervention Type PROCEDURE

Standard noninvasive vascular monitoring

Standard noninvasive vascular monitoring of blood pressure, pulse rate, pulse oximetry and respiratory rate.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing right heart catheterization or left and right heart catheterizaton; Age \>=18


* Cardiopulmonary bypass for cardiac procedures within one hour of arriving in the ICU post-op; Age \>=18


* Hospitalized patients with central venous access and pulmonary arterial catheter in place, requiring infusion of vasoactive and/or inotropic agents; Age \>=18


* Patients presenting to Vanderbilt University Medical Center with the diagnosis of congestive heart failure and present with symptoms of fluid overload; Age\>=18


* Patients with atrial fibrillation undergoing direct current cardioversion; Age \>=18


* Patients presenting for surgery requiring positive pressure ventilation and arterial line placement; Age \>=18

Exclusion Criteria

* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extra corporeal membrane oxygenation), ongoing ACLS, aortic or mitral valve disease greater than mild in severity, aortic or mitral valve replacement, active irregular heart rhythm, patients with restrictive cardiomyopathies (cardiac amyloidosis), constrictive cardiac disease (constrictive pericarditis or cardiac-tamponade), congenital heart disease other than foramen ovale, repaired atrial or ventricular septal defect, female patients who are pregnant or lactating, or patients with known psychiatric or neurological disease who are unable to consent. Patients who do not have a functional peripheral IV as part of standard care. Pressors, starches, lipids, propofol, or D10 or higher running through the PIVA line.

Distributive Shock


* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extracorporeal membrane oxygenation), ongoing ACLS, severe tricuspid regurgitation or stenosis, patient with restrictive cardiomyopathies (cardiac amyloidosis), patients receiving pulmonary vasodilators (nitric oxide, sodium nitroprusside, sildenafil), atrial fibrillation, congenital heart disease, female patients who are pregnant or lactating, or patients with known psychiatric or neurological disease who are unable to consent. Patients who do not have a functional peripheral IV as part of standard care.

Vasoactive and Inotropic Agents


* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extracorporeal membrane oxygenation), ongoing ACLS, severe tricuspid regurgitation or stenosis, patient with restrictive cardiomyopathies (cardiac amyloidosis), patients receiving pulmonary vasodilators (nitric oxide, sodium nitroprusside, sildenafil), atrial fibrillation, congenital heart disease, female patients who are pregnant or lactating, or patients with known psychiatric or neurological disease who are unable to consent. Patients who do not have a functional peripheral IV as part of standard care.

Congestive Heart Failure


* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extra corporeal membrane oxygenation), ongoing ACLS, active irregular heart rhythm, patient with restrictive cardiomyopathies (cardiac amyloidosis), or constrictive cardiac disease (constrictive pericarditis or cardiac tamponade), congenital heart disease other than foramen ovale, repaired atrial or ventricular septal defect, female patients who are pregnant or lactating, or patients with known psychiatric or neurological disease who are unable to consent. Patients who do not have a functional peripheral IV as part of standard care.

Atrial Fibrillation (undergoing elective direct current cardio version)


* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extra corporeal membrane oxygenation), ongoing ACLS, patients with restrictive cardiomyopathies (cardiac amyloidosis) or constrictive cardiac disease (constrictive pericarditis or cardiac tamponade), congenital heart disease other than foramen ovale, repaired atrial or ventricular septal defect, female patients who are pregnant or lactating, or patients with known psychiatric or neurological disease who are unable to consent. Patients who do not have a functional peripheral IV as part of standard care.

Patients undergoing Surgery


* Cardiac assist devices (intra-aortic balloon pump, ventricular assist devices, and extra corporeal membrane oxygenation), ongoing ACLS, patients with restrictive cardiomyopathies (cardiac amyloidosis) or constrictive cardiac disease (constrictive pericarditis or cardiac tamponade), active irregular cardiac rhythm, congenital heart disease other than foramen ovale , repaired atrial or ventricular septal defect, female patients who are pregnant or lactating, patients with known psychiatric or neurological disease who are unable to consent, or any other medical condition which, in the opinion of the investigator, would place the patient at undue risk from participation in the trial. Patients who do not have a functional peripheral IV as part of standard care.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Kelly Kohorst

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kelly L. Kohorst, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Other Identifiers

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828397

Identifier Type: -

Identifier Source: org_study_id

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