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Observational Study
. 2017 Sep 27;7(9):e017170.
doi: 10.1136/bmjopen-2017-017170.

Clinical examination, critical care ultrasonography and outcomes in the critically ill: cohort profile of the Simple Intensive Care Studies-I

Bart Hiemstra  1 , Ruben J Eck  1 , Geert Koster  1 , Jørn Wetterslev  2 , Anders Perner  3 , Ville Pettilä  4 , Harold Snieder  5 , Yoran M Hummel  6 , Renske Wiersema  1 , Anne Marie G A de Smet  1 , Frederik Keus  1 , Iwan C C van der Horst  1 ; SICS Study Group
Affiliations
Observational Study

Clinical examination, critical care ultrasonography and outcomes in the critically ill: cohort profile of the Simple Intensive Care Studies-I

Bart Hiemstra et al. BMJ Open. .

Abstract

Purpose: In the Simple Intensive Care Studies-I (SICS-I), we aim to unravel the value of clinical and haemodynamic variables obtained by physical examination and critical care ultrasound (CCUS) that currently guide daily practice in critically ill patients. We intend to (1) measure all available clinical and haemodynamic variables, (2) train novices in obtaining values for advanced variables based on CCUS in the intensive care unit (ICU) and (3) create an infrastructure for a registry with the flexibility of temporarily incorporating specific (haemodynamic) research questions and variables. The overall purpose is to investigate the diagnostic and prognostic value of clinical and haemodynamic variables.

Participants: The SICS-I includes all patients acutely admitted to the ICU of a tertiary teaching hospital in the Netherlands with an ICU stay expected to last beyond 24 hours. Inclusion started on 27 March 2015.

Findings to date: On 31 December 2016, 791 eligible patients fulfilled our inclusion criteria of whom 704 were included. So far 11 substudies with additional variables have been designed, of which six were feasible to implement in the basic study, and two are planned and awaiting initiation. All researchers received focused training for obtaining specific CCUS images. An independent Core laboratory judged that 632 patients had CCUS images of sufficient quality.

Future plans: We intend to optimise the set of variables for assessment of the haemodynamic status of the critically ill patient used for guiding diagnostics, prognosis and interventions. Repeated evaluations of these sets of variables are needed for continuous improvement of the diagnostic and prognostic models. Future plans include: (1) more advanced imaging; (2) repeated clinical and haemodynamic measurements; (3) expansion of the registry to other departments or centres; and (4) exploring possibilities of integration of a randomised clinical trial superimposed on the registry.

Study registration number: NCT02912624; Pre-results.

Keywords: Accident & emergency medicine; Adult intensive & critical care; Cardiology; Echocardiography; Epidemiology; Ultrasonography.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Timeline of basic study line and substudies. The substudies are explained in table 1. AKI, acute kidney injury; ARDS, acute respiratory distress syndrome; NIRS, near-infrared spectroscopy; PEEP, positive end-expiratory pressure; RV, right ventricular; SICS, Simple Intensive Care Studies.
Figure 2
Figure 2
Flow diagram of the Simple Intensive Care Studies-I (SICS-I) cohort. CCUS, critical care ultrasonography
See this image and copyright information in PMC

References

    1. Sakr Y, Reinhart K, Vincent JL, et al. . Does dopamine administration in shock influence outcome? Results of the Sepsis Occurrence in Acutely Ill Patients (SOAP) Study. Crit Care Med 2006;34:589–97. 10.1097/01.CCM.0000201896.45809.E3 - DOI - PubMed
    1. De Backer D, Biston P, Devriendt J, et al. . Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010;362:779–89. 10.1056/NEJMoa0907118 - DOI - PubMed
    1. Vincent JL, Marshall JC, Namendys-Silva SA, et al. . Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit. Lancet Respir Med 2014;2:380–6. 10.1016/S2213-2600(14)70061-X - DOI - PubMed
    1. Cecconi M, De Backer D, Antonelli M, et al. . Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 2014;40:1795–815. 10.1007/s00134-014-3525-z - DOI - PMC - PubMed
    1. Cholley BP, Vieillard-Baron A, Mebazaa A. Echocardiography in the ICU: time for widespread use!. Intensive Care Med 2006;32:9–10. 10.1007/s00134-005-2833-8 - DOI - PubMed

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