Assessment of volume status and volume responsiveness in the ICU: protocol for an observational, multicentre cohort study

Luis F. Schulz, Guillaume Geri, Antoine Vieillard-Baron, Philippe Vignon, Geoffrey Parkin, Anders Aneman

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Expansion of the intravascular compartment is common to treat haemodynamic instability in ICU patients. The most useful and accurate variables to guide and evaluate a fluid challenge remain debated and incompletely investigated resulting in significant variability in practice. The analogue mean systemic pressure has been reported as a measure of the intravascular volume state. Methods: This is a protocol and statistical analysis plan for a review of the application of an analogue of the mean systemic pressure and the use of derived variables to assess the volume state and volume responsiveness. A pulmonary artery catheter was used in 286 postoperative cardiac surgical patients to monitor cardiac output before and after a fluid bolus in addition to arterial and central venous pressures. With otherwise similar monitoring, echocardiography was used in 540 general ICU patients to determine cardiac outputs and indices related to intravascular filling. The responses to a fluid bolus or the passive leg raising manoeuvre will be investigated using continuous and dichotomous definitions of volume responsiveness. The results will be stratified according to the method of monitoring cardiac output. Conclusions: This study investigating 2 cohorts that encompass a wide variety of reasons for haemodynamic instability will illustrate the applicability of the analogue mean systemic pressure and derived variables to assess the volume state and responsiveness. The results may guide the rationale and design of interventional studies.

LanguageEnglish
Pages1102-1108
Number of pages7
JournalActa Anaesthesiologica Scandinavica
Volume63
Issue number8
Early online date22 May 2019
DOIs
Publication statusPublished - Sep 2019

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Cardiac Output
Multicenter Studies
Cohort Studies
Pressure
Hemodynamics
Central Venous Pressure
Pulmonary Artery
Echocardiography
Leg
Catheters

Cite this

Schulz, Luis F. ; Geri, Guillaume ; Vieillard-Baron, Antoine ; Vignon, Philippe ; Parkin, Geoffrey ; Aneman, Anders. / Assessment of volume status and volume responsiveness in the ICU : protocol for an observational, multicentre cohort study. In: Acta Anaesthesiologica Scandinavica. 2019 ; Vol. 63, No. 8. pp. 1102-1108.
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Assessment of volume status and volume responsiveness in the ICU : protocol for an observational, multicentre cohort study. / Schulz, Luis F.; Geri, Guillaume; Vieillard-Baron, Antoine; Vignon, Philippe; Parkin, Geoffrey; Aneman, Anders.

In: Acta Anaesthesiologica Scandinavica, Vol. 63, No. 8, 09.2019, p. 1102-1108.

Research output: Contribution to journalArticleResearchpeer-review

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