Respiratory Variations For Predicting Fluid Responsiveness 2 (ReVaPreF2)
Sepsis, Circulatory Failure, Respiratory Physiological Phenomena
About this trial
This is an interventional diagnostic trial for Sepsis focused on measuring vena cava, fluid, sepsis, echocardiography, ultrasound, ultrasonography, collapsibility index, circulatory failure, irregular cardiac rhythm, fluid responsiveness, Spontaneous breathing
Eligibility Criteria
Inclusion Criteria:
- Adult patients of the intensive care units of the Lille university-hospital and of the Valencienne general hospital.
- Age greater than or equal to 18.
- Patient insured
- Spontaneous breathing without ventilatory support or intubation or tracheotomy.
- Irregular cardiac rhythm
- Prescription by the physician in charge of the patients of a 500 mL volume expansion in less than 30 minutes.
Patients with sepsis with at least one sign of acute circulatory failure:
- Tachycardia with heart rate> 100/min
- systolic blood pressure <90mmHg or a decrease >40mmHg in previously hypertense patient
- Oliguria <0.5ml/kg/hour for at least one hour
- skin mottling
Exclusion Criteria:
- high-grade aortic insufficiency
- transthoracic echogenicity unsuitable for measuring the stroke volume or inferior vena cava diameters
- clinical signs of active exhalation
- clinical or ultrasonographic evidence of pulmonary edema due to heart failure
- pregnancy
- abdominal compartment syndrome
- regular cardiac rhythm
Sites / Locations
- Intensive Care Department, Salengro Hospital,CHRU
Arms of the Study
Arm 1
Experimental
Echocardiography-Doppler
Ultrasonographic recordings, systemic arterial pressure, heart rate, and respiratory rate are recorded immediately before and after volume expansion (VE), performed as a 30-minute infusion of 500 mL of 4% gelatin. Inferior Vena Cava diameters are measured during spontaneous and standardized respiratory cycles. Stroke volume is measured during spontaneous respiratory cycles.