CompletedNot Applicable

Echocardiographic Parameters for Hemodynamic Support During CVVHDF

Turkey (Türkiye)40 participantsStarted 2025-06-23

Plain-language summary

This prospective observational study aims to evaluate whether transthoracic echocardiographic parameters-Left Ventricular Outflow Tract Velocity-Time Integral (LVOT VTI), Mitral Annular Plane Systolic Excursion (MAPSE), Tricuspid Annular Plane Systolic Excursion (TAPSE), S' wave velocity, and E/e' ratio-can predict hemodynamic instability at the initiation of sustained low-efficiency daily dialysis (SVVHDF) in intensive care unit (ICU) patients. The study will include adult patients requiring SVVHDF, and echocardiographic measurements will be performed prior to dialysis. The primary outcome is the need for hemodynamic support (vasopressors/inotropes or fluid resuscitation) or development of hypotension within the first 60 minutes of dialysis. The study aims to identify which of these parameters best predict the need for hemodynamic intervention, with the goal of supporting individualized dialysis planning and safer fluid management in critically ill patients.

Who can participate

Age range18 Years

SexALL

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Inclusion Criteria: * Age ≥18 years * Admission to the intensive care unit (ICU) * Clinical indication for initiation of continuous veno-venous hemodiafiltration (CVVHDF) * Ability to obtain adequate transthoracic echocardiographic (TTE) images prior to CVVHDF * Written informed consent obtained from the patient's legal representative Exclusion Criteria: * Acute coronary syndrome, severe valvular disease, or pericardial effusion affecting cardiac function * Cardiac arrhythmias such as atrial fibrillation or ventricular tachycardia that interfere with accurate Doppler measurements * Presence of cardiac devices such as pacemakers, LVADs, or implantable cardioverter defibrillators (ICDs) * Poor echocardiographic window due to severe lung disease or chest wall abnormalities * Estimated life expectancy \<24 hours or do-not-resuscitate (DNR) orders in place * Inability to obtain informed consent due to lack of legal representative * Transfer to another facility before CVVHDF initiation or change in renal replacement strategy (e.g., switch to peritoneal dialysis) * Incomplete echocardiographic measurement due to technical limitations

What they're measuring

Occurrence of Hemodynamic Instability Within the First 60 Minutes of CVVHDF and Its Association With Pre-Dialysis LVOT VTI

Timeframe: Within the first 60 minutes of CVVHDF initiation

Trial details

NCT IDNCT07019051

SponsorKanuni Sultan Suleyman Training and Research Hospital

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2026-01-13