Mortality in critically ill patients, especially those with shock or acute respiratory distress syndrome, remains very high. One of the main methods of treating critically ill patients is the correct intravenous fluid dosing. However, studies have shown that too much or too little fluid infusion increases mortality. So far there is only one validated method, such as passive leg raising, suitable for a variety of critical conditions. During passive leg raising, the change in body position from semi-sitting to raised legs causes fluid redistribution and thus changes in hemodynamics without additional fluid infusion. Based on this circulatory response, a decision is made on the need for further fluid infusion. However, its technical performance is not so simple when the patient is initially placed in a semi-sitting position and then laid down and legs raised. It may also not be used in all patients, such as patients with spinal cord injury, abdominal or leg pathology. We observed that a much simpler induction of fluid redistribution could be the induction of a sympathetic stimulus occurring during prolonged retention of an inflated blood pressure cuff. Also, this extended cuff clamp is used during remote ischemic conditioning (RIC). The RIC is non-invasive procedure and uses a blood pressure cuff and does not require movement of the patient’s body. It is suitable for all patients without exception. In addition, RIC performs therapeutic effects that have been demonstrated in a number of clinical studies. The objective of the project is to determine the effect of remote ischemic conditioning on hemodynamics, its relationship to blood volume deficit and to develop an automated non-invasive device-prototype for remote ischemic conditioning (NIRIC prototype) performance and blood volume assessment in critical ill patients. Such a blood volume assessment methodology is new and completely non-invasive and easy to perform, suitable for all patients.
Project funding:
Projects funded by the Research Council of Lithuania (RCL), Projects carried out by researchers’ teams
Period of project implementation: 2023-04-01 - 2026-02-28
Project coordinator: Lithuanian University of Health Sciences
Project partners: Kaunas University of Technology
