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Echocardiographic measurement of inferior vena cava (IVC) collapsibility index (CI) with automated software analyses has been introduced. This study aims to assess the accuracy of IVC-CI (caval index) measurements as well as the ability to track fluid responsiveness (FRes) over time comparing the automated echocardiographic method with the pulse pressure variation (PPV) technique and the manual echocardiographic method in cardiac surgery patients.
It is expected to have insights about the concordance rate. The automated echocardiographic method of measuring CI method may or may not meet the criteria for interchangeability with the thermodilution technique or the manual echocardiographic method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| All patients | The IVC will be measured by the automated mode and manual measures will be recorded. All patients will have PPv by LiDCO |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Automated echocardiographic inferior vena cava measurement | Diagnostic Test | Patients will be place in supine position. view: subcostal view, importantly supine is standard position for IVC measurement, the IVC is larger in the right lateral decubitus position and vice versa, alternatively directly through a transhepatic approach. Measures will be performed in the two dimensional mode close to the hepatic vein (1 - 3cm from the IVC connection to the right atrium). The IVC will be measured by MM-Mode manually and with the automated mode (both measures will be recorded. In the manual mode this measure requires concurrent utilization of M-Mode and two dimensional mode |
| Measure | Description | Time Frame |
|---|---|---|
| Fluid responsiveness rate 500cc of colloids over 10 min. | defined as increase in the stoke volume by 15% after infusion of 500cc of colloids | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| HR | before and after the fluid challenge | 30 minutes |
| MAP | before and after the fluid challenge | 30 minutes |
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Inclusion Criteria:
Exclusion Criteria:
-1. Contraindication for fluid administration including acute pulmonary edema. 2. Moderate or more tricuspid valve lesion or pulmonary hypertension (more 50 mmHg) where high central venous pressure is expected 3. Patients on hemodialysis. 4. Patient on intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) 5. Irregular cardiac rhythm: patients with atrial fibrillation or frequent ectopics are excluded.
6. Patients with chest open 7. Poor echocardiography window (The images will be stored and analyzed by senior physician within the ICU certified in echocardiography)
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A prospective, descriptive, single-center study that will examine three techniques for guiding fluid therapy. Patients who are in need of fluid therapy will be identified. The study will be conducted over one year after the approval of the ethical committee. Patients after cardiac surgery will be recuited
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amr S Omar, Md, PhD | Contact | 44395897 | a_s_omar@yahoo.com | |
| Praveen Sivadasan, MD | Contact | 44395897 | PSivadasan@hamad.qa |
| Name | Affiliation | Role |
|---|---|---|
| Amr Omar, Md, PhD | Hamad medical corproation | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hamad medical corporation | Recruiting | Doha | 3050 | Qatar |
No allowed by our corporate
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| VTI | before and after the fluid challenge | 30 minutes |