Ultrasound-Based Prediction of Hemodynamic Instability During CVVHDF Initiation

Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorBursa Yuksek Ihtisas Training and Research Hospital

About this trial

This prospective observational study aims to evaluate the ability of transthoracic echocardiographic and bedside ultrasonographic parameters to predict intradialytic hypotension and hemodynamic instability at the initiation of continuous venovenous hemodiafiltration (CVVHDF) in adult intensive care unit patients.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult patients (≥18 years) admitted to the intensive care unit

Indication for continuous venovenous hemodiafiltration

Adequate transthoracic echocardiographic image quality

Written informed consent obtained from legal representatives

Disqualifiers

Acute coronary syndrome

Severe valvular heart disease or pericardial effusion

Significant arrhythmias interfering with Doppler measurements

Presence of pacemaker, ICD, or ventricular assist device

Trial population

The study population consists of adult patients (aged 18 years and older) admitted to the intensive care unit of a tertiary care academic hospital who have a clinical indication for continuous venovenous hemodiafiltration (CVVHDF). All participants are critically ill and require renal replacement therapy as part of standard clinical care. Transthoracic echocardiography and bedside ultrasonographic and hemodynamic assessments are performed as part of routine intensive care evaluation and are recorded for observational purposes only. No healthy volunteers are included in this study. Written informed consent is obtained from the patients' legal representatives prior to study inclusion.

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

Not listed

Trial groups

No trial groups listed

Trial outcomes

Primary outcomes

1

Hemodynamic Instability During CVVHDF Initiation

Occurrence of hypotension (mean arterial pressure \<65 mmHg), requirement for fluid bolus (≥500 mL), or initiation/increase of vasopressor or inotrope support within the first 60 minutes after CVVHDF initiation.

Time frame
First 60 minutes after CVVHDF initiation

Secondary outcomes

1

LVOT Velocity Time Integral

Measurement of left ventricular outflow tract velocity time integral obtained by transthoracic echocardiography before dialysis initiation.

Time frame
Before CVVHDF initiation
2

Mitral Annular Plane Systolic Excursion (MAPSE)

Measurement of mitral annular plane systolic excursion obtained by M-mode transthoracic echocardiography in the apical four-chamber view to assess left ventricular longitudinal systolic function prior to CVVHDF initiation.

Time frame
Before CVVHDF initiation
3

Tricuspid Annular Plane Systolic Excursion (TAPSE)

Measurement of tricuspid annular plane systolic excursion obtained by M-mode transthoracic echocardiography in the apical four-chamber view to evaluate right ventricular systolic function prior to CVVHDF initiation.

Time frame
Before CVVHDF initiation
4

Pulse Pressure Variation (PPV)

Calculation of pulse pressure variation derived from invasive arterial blood pressure waveform analysis in mechanically ventilated patients to assess dynamic preload responsiveness prior to CVVHDF initiation.

Time frame
Before CVVHDF initiation

Other outcomes

Locations

This trial has no locations.

Sponsors and contacts

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Bursa Yuksek Ihtisas Training and Research Hospital

Lead sponsor

Kanuni Sultan Suleyman Training and Research Hospital

Sponsor institution

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