Role of Echocardiography and Ultrasound Indices in Resuscitation of Septic Shock Patients

ConditionsSeptic Shock Fluid Resuscitation

Trial statusRecruiting

Trial phaseNot listed

Trial typeObservational

Biological sexAll

Age18-50

SponsorAin Shams University

About this trial

Fluid replacement is considered the cornerstone of hemodynamic management in critically ill patients especially in patients with septic shock. However, only about 50% of critically ill hemodynamically unstable patients are responsive to fluids. Consequently, the resuscitation of critically ill patients requires an accurate assessment of the patients' intravascular volume status and their volume responsiveness. In this study, we will compare the efficacy of carotid artery flow to echo left ventricular end diastolic volume as a predictive value for fluid resuscitation in septic shock patients.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

▪ Age:18-50 years old

Sex: both males &females.

Patients diagnosed with septic shock according to SOFA score more than or equal 1

Low blood pressure (mean arterial pressure <65 mmHg and / or systolic <90 mmHg).

Disqualifiers

▪ Known significant valvular heart disease (sever aortic insufficiency or stenosis)

Known carotid artery stenosis >50% or previous carotid surgery

Clear contraindication to the carotid artery Doppler such as wound or infection or complete or partial occlusion of the carotid artery.

Arrhythmias affect stroke volume assessment (atrial fibrillation, frequent PVCs)

Trial population

septic shock patients in ICU

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

carotid artery duplex
Procedure/Surgery
, Carotid Doppler (T0) will be performed within 1-2 Hours of ICU Admission to measure the following parameters: "Peak systolic velocity" and Velocity Time Integral over the common carotid artery. Using the linear probe (VF12-4) of ultrasound machine (ACUSON NX3, Siemens Medical solution USA, Inc.) * According to surviving sepsis campaign guidelines 2021, patients diagnosed with septic shock should be given 30ml/kg IV crystalloid fluid within the first 3 hours, the fluid will be given in the form of 500 ml boluses, each bolus should be given in 15 minutes. * FC "fluid challenge" will be performed by rapid volume infusion over (30minutes) of 1000mL Ringer acetate solution. * Carotid artery Duplex parameters will be repeated. Relative changes in "Peak Systolic Velocity, Velocity Time integral" will be expressed in
Left ventricular end diastolic area
Procedure/Surgery
* Echocardiography (T0) will be performed within 1-2 Hours of ICU Admission to measure LVEDA if less than 10 cm2 then the patient will be considered hypovolemic. * According to surviving sepsis campaign guidelines 2021, patients diagnosed with septic shock should be given 30ml/kg IV crystalloid fluid within the first 3 hours, the fluid will be given in the form of 500 ml boluses, each bolus should be given in 15 minutes. * FC "fluid challenge" will be performed by rapid volume infusion over (30minutes) of 1000mL Ringer acetate solution. * After five minutes from FC "fluid challenge" (T1), echocardiography will be repeated to re-measure LVEDA. Pt will be defined as a responder if LVEDA b

Treatment groups

40 Participants

are divided into 1 treatment group

Group A: septic shock patients2 interventions

Trial outcomes

Primary outcomes

Accuracy of echo and ultrasound indices

Diagnostic accuracy (sensitivity, specificity) of LVEDA and carotid artery flow parameters (PEAK Systolic Velocity, Velocity time integral (VTI), in predicting fluid responsiveness defined as an increase in stroke volume after a standardized fluid challenge.

Time frame

1 Day

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Ain Shams University

Lead sponsor

Source ClinicalTrials.gov

Apply now