Ignite Creation Date:
2024-05-06 @ 8:13 PM
Last Modification Date:
2024-10-26 @ 3:22 PM
Study NCT ID:
NCT06295445
Status:
COMPLETED
Last Update Posted:
2024-03-12
First Post:
2024-02-21
Brief Title:
Impact of Integrated Cardiopulmonary Ultrasound on Clinical Outcome of Shocked Patients in Intensive Care Unit
Sponsor:
Egymedicalpedia
Organization:
Egymedicalpedia
Study Overview
Official Title:
Impact of Integrated Cardiopulmonary Ultrasound on Clinical Outcome of Shocked Patients in Intensive Care Unit
Status:
COMPLETED
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Shock is one of the most common conditions in the intensive care unit ICU affecting one-third of critically ill patients It reduces oxygen and nutritions perfusion to the solid organs and is closely associated with increased mortality Most literature has described how hemodynamic monitoring could provide an effective way to identify underlying pathophysiological processes and guide appropriate therapy in shock patients
Detailed Description:
The diagnosis of shock is based on clinical hemodynamic and biochemical signs It is manifested with systemic arterial hypotension with mean arterial pressure less than 70 mm Hg with reflex tachycardia Also there are clinical signs of tissue hypoperfusion including cutaneous hypoperfusion with cold clammy skin renal hypoperfusion with resulting oliguria urine output UOP 05 mlkgh and neurologic hypoperfusion with altered mental state Tissue hypoperfusion leads to anaerobic tissue metabolism with hyperlactatemia 15 mmolL
Assessment of hemodynamic status and lines of management of the acute circulatory shock remains a challenging issue in emergency medicine and critical care As the use of invasive hemodynamic monitoring declines bedside-focused ultrasound US has become a valuable tool in the evaluation and management of patients in shock
Four types of shock exist including hypovolemic cardiogenic distributive and obstructive shock Clinical assessment and classification of shock is extremely difficult in critically ill patients as there is sometimes an overlap between these types Incorporation of bedside ultrasound in patients with undifferentiated shock allows for rapid evaluation of reversible causes of shock and improves accurate diagnosis in undifferentiated hypotension
Currently the critical care ultrasound CCUS has been widely advocated as the preferred tool to assess hemodynamics including accurately estimating pathophysiological changes of shock This information therefore can be carried out into protocols to guide shock treatment However despite previous recommendations current protocols are subjective and empirical without listing specific variables as indicators such as ejection fraction EF mitral annular plane systolic excursion MAPSE tricuspid annular plane systolic excursion TAPSEmitral or tricuspid annular peak systolic velocity S-MV or S-TV inferior vena cava IVC and lung ultrasound score LUSS
CCUS examination on ICU admission which performed by the experienced physician provide valuable information to assist the caregivers in understanding the comprehensive outlook of the characteristics of hemodynamics and lung pathology Those key variables obtained by CCUS predict the possible prognosis of patients hence deserve more attention in clinical decision making
Lung ultrasound has been widely used in diagnosing pulmonary diseases including pneumonia connective tissue diseases and interstitial lung diseases For patients in the intensive care unit ICU more attention is paid to monitoring the development of lung pathologic changes which guides the therapy Lung insults caused by inflammation trauma or water increase always lead to infiltration which results in the loss of lung air Depending on the severity of the aeration loss and water increase each part of the lung generates different ultrasound signs upon exam
The lung ultrasound score LUSS is the sum of the scores of each exam zone and has been justified as a respectable semiquantitative score to measure the lung aeration loss caused by different lung pathologic changes such as pneumonia atelectasis pleural effusion and lung edema
Lung Ultrasound Protocol LUSS Reliable techniques have been used based on the international evidence-based recommendations for point-of-care lung ultrasound that recommended using a complete eight-zone lung ultrasound examination to evaluate the LUSS The anterior and lateral chest wall are divided into eight areas Areas 1 and 2 denote the upper anterior and lower anterior chest areas respectively and areas 3 and 4 denote the upper lateral and basal lateral chest areas respectively
Assessment of hemodynamic status and lines of management of the acute circulatory shock remains a challenging issue in emergency medicine and critical care As the use of invasive hemodynamic monitoring declines bedside-focused ultrasound US has become a valuable tool in the evaluation and management of patients in shock
Four types of shock exist including hypovolemic cardiogenic distributive and obstructive shock Clinical assessment and classification of shock is extremely difficult in critically ill patients as there is sometimes an overlap between these types Incorporation of bedside ultrasound in patients with undifferentiated shock allows for rapid evaluation of reversible causes of shock and improves accurate diagnosis in undifferentiated hypotension
Currently the critical care ultrasound CCUS has been widely advocated as the preferred tool to assess hemodynamics including accurately estimating pathophysiological changes of shock This information therefore can be carried out into protocols to guide shock treatment However despite previous recommendations current protocols are subjective and empirical without listing specific variables as indicators such as ejection fraction EF mitral annular plane systolic excursion MAPSE tricuspid annular plane systolic excursion TAPSEmitral or tricuspid annular peak systolic velocity S-MV or S-TV inferior vena cava IVC and lung ultrasound score LUSS
CCUS examination on ICU admission which performed by the experienced physician provide valuable information to assist the caregivers in understanding the comprehensive outlook of the characteristics of hemodynamics and lung pathology Those key variables obtained by CCUS predict the possible prognosis of patients hence deserve more attention in clinical decision making
Lung ultrasound has been widely used in diagnosing pulmonary diseases including pneumonia connective tissue diseases and interstitial lung diseases For patients in the intensive care unit ICU more attention is paid to monitoring the development of lung pathologic changes which guides the therapy Lung insults caused by inflammation trauma or water increase always lead to infiltration which results in the loss of lung air Depending on the severity of the aeration loss and water increase each part of the lung generates different ultrasound signs upon exam
The lung ultrasound score LUSS is the sum of the scores of each exam zone and has been justified as a respectable semiquantitative score to measure the lung aeration loss caused by different lung pathologic changes such as pneumonia atelectasis pleural effusion and lung edema
Lung Ultrasound Protocol LUSS Reliable techniques have been used based on the international evidence-based recommendations for point-of-care lung ultrasound that recommended using a complete eight-zone lung ultrasound examination to evaluate the LUSS The anterior and lateral chest wall are divided into eight areas Areas 1 and 2 denote the upper anterior and lower anterior chest areas respectively and areas 3 and 4 denote the upper lateral and basal lateral chest areas respectively
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None