Passive Leg Raise and Mini-fluid Challenge Effect on Various Cardiac Output Surrogates for Fluid Responsiveness

Description

In the critically ill population, fluid administration in an unstable patient is perhaps the most common intervention that is performed. Uncorrected hypovolemia with inappropriate vasopressors lead to organ hypoperfusion where as overzealous fluid administration especially in ARDS (Adult respiratory distress syndrome) can increase mortality. It has been estimated that only 50% of hemodynamically unstable critically ill patients are volume responsive, hence dynamic assessment of preload responsiveness has been proposed to better identify those individuals who would benefit from fluid bolus.

Conditions

Fluid Responsiveness

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Study Overview

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Study Details

Study overview

In the critically ill population, fluid administration in an unstable patient is perhaps the most common intervention that is performed. Uncorrected hypovolemia with inappropriate vasopressors lead to organ hypoperfusion where as overzealous fluid administration especially in ARDS (Adult respiratory distress syndrome) can increase mortality. It has been estimated that only 50% of hemodynamically unstable critically ill patients are volume responsive, hence dynamic assessment of preload responsiveness has been proposed to better identify those individuals who would benefit from fluid bolus.

Passive Leg Raise and Mini-fluid Challenge Effect on Various Cardiac Output Surrogates Such as Pulse Pressure Variation (PPV), End-tidal CO2 (Carbon Dioxide), Bioreactance (Stroke Volume Index -SVI) and Velocity Time Integral on Echocardiographic Exam for Fluid Responsiveness in Patients With Moderately Severe ARDS (Acute Respiratory Distress Syndrome)

Passive Leg Raise and Mini-fluid Challenge Effect on Various Cardiac Output Surrogates for Fluid Responsiveness

Condition
Fluid Responsiveness
Intervention / Treatment

-

Contacts and Locations

Saint Cloud

St Cloud Hospital, Saint Cloud, Minnesota, United States, 56303

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age between 30 - 90 years
  • * Diagnosis of Vasodilatory Shock with no other obvious cause of hypotension
  • * Diagnosis of ARDS with PF ratio \< 150 , PEEP \> 8
  • * Patients who are under paralysis or deeply sedated, on a mechanical ventilator
  • * Patients with arrhythmias including atrial fibrillation
  • * Patients with chest tube, intra-abdominal hypertension or with its risk factors
  • * Patients with structural heart disease including pulmonary hypertension (RVSP \> 45) and heart failure
  • * Patients on extracorporeal support such as ECMO, CRRT or MCS.
  • * Patients with COPD with a premorbid FEV1 \< 1.5 L
  • * Severe atherosclerotic vascular disease

Ages Eligible for Study

30 Years to 90 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

CentraCare,

Ramakanth Pata, MD FCCP, PRINCIPAL_INVESTIGATOR, Centracare health System

Study Record Dates

2025-06