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โ† Trials
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Fluid Responsiveness Prediction During Prone Position

RecruitingNAAges 18 Years - anyAllHospices Civils de Lyon
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In plain words

What the trial is, and whether it could suit you

Predicting fluid responsiveness is primordial when caring for patients with circulatory shock as it allows correction of preload-dependent low cardiac output states, while preserving patients of the deleterious effects of excessive fluid resuscitation. Patients with severe acute respiratory distress syndrome (ARDS) treated with prone positioning (PP) are a specific subset of patients, as 1) they frequently present with shock; 2) excessive fluid administration may lead to respiratory worsening due to increased hydrostatic oedema with potential subsequent worse clinical outcome; and 3) all available dynamic tests evaluating fluid responsiveness can only be performed in patients in the supine condition (which in the case of severe ARDS patients in PP occurs only for 8h over 24h). These elements warrant the development of specific tests allowing the clinician to predict fluid responsiveness

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๐Ÿ“‹ Eligibility rules (as published)
Inclusion Criteria: * adult patient (including patient under protective measures/wardship) * with ARDS as defined by the Berlin criteria * in the prone position as per international guidelines * with a calibrated continuous cardiac output monitoring device * with a clinical indication for a fluid bolus as prescribed by the clinician in charge, and fulfilling at least 2 clinical criteria: mottles, tachycardia, hypotension, drop in cardiac output, oliguria, high arterial lactate concentration, or any other detailed criterion * with no respiratory efforts Exclusion Criteria: * acute cor pulmonale * patient treated with veno-venous extra-corporeal membrane oxygenation * hemorrhagic shock * Child-Pugh C cirrhosis * death expected to occur in less than 24h * decision to withhold or suspend active treatments * intracranial hypertension * lower limb amputation * obstruction of the inferior vena cava * acute abdominal syndrome * absence of consent to participate * pregnancy * patient previously enrolled in the same study * lack of affiliation to a social security regimen, as per French legislation * patient deprived of its liberty
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What it tests

  • Trendelenburg maneuver
  • End-expiratory occlusion test (EE OCC)
  • End-expiratory and end-inspiratory occlusion test (EI OCC)
  • Tidal volume challenge
  • Fluid bolus (reference diagnostic method)
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Where

4 sites
CHU Gabriel Montpied
Clermont-Ferrand, France
Hรดpital de la Croix Rousse, Hospices Civils de Lyon
Lyon, France
CHU de Nice - l'Archet 1
Nice, France
CHU Nice - Pasteur 2
Nice, France
๐Ÿค Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible โ€” always decide together with your own doctor.
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