FRESH Study Results Show Passive Leg Raise May Predict Cardiac Dysfunction in Septic Shock Patients

Cheetah Medical, a leader in non-invasive fluid management devices, has announced new results of a sepsis data analysis leveraging its technology. The findings from the ongoing Fluid Responsiveness Evaluation in Sepsis-associated Hypotension (FRESH) study continue to indicate that the simple bedside test of whether the heart can handle additional IV fluid (fluid responsiveness) may be helpful in identifying patients with underlying cardiac dysfunction.
 
In this analysis, approximately 95 to 100 percent of septic shock patients who did not demonstrate fluid responsiveness during the first 24 hours of hospital care had evidence of underlying cardiac dysfunction.
 
Previous studies have demonstrated that the ability of the heart to handle additional IV fluid (fluid responsiveness) is dynamic—changing frequently in patients with septic shock. Fluid responsiveness can be assessed by performing a simple bedside maneuver called a Passive Leg Raise while monitoring cardiac stroke volume. These particular patients remained fluid non-responsive during the first 24 hours of observation. Sepsis is known to negatively impact cardiac function.
 
“These data indicate testing sepsis patients periodically for fluid responsiveness during the dynamic first 72 hours of a sepsis episode can be helpful in detecting any underlying cardiac dysfunction,” said Ivor Douglas, M.D., FRCP, Denver Health Medical Center. “We know cardiac function loss is a major risk for sepsis patients, so it’s advantageous for clinicians and for patient outcomes to have a method for identifying underlying cardiac deficits and loss of function as early as possible.”
 
“Dr. Douglas’ work contributes to the growing body of evidence indicating fluid responsiveness cannot be measured solely at the beginning and end of the critical 72-hour sepsis monitoring window,” said Chris Hutchison, president and CEO of Cheetah Medical. “We are very encouraged by these and other interim results from the FRESH study in demonstrating the importance of periodic assessment in reducing the risk of cardiac dysfunction in sepsis patients.”
 
The Fluid Responsiveness Evaluation in Sepsis-associated Hypotension study (FRESH), which continues to enroll patients, is a prospective, randomized, controlled study evaluating the incidence of fluid responsiveness (FR) in critically ill patients with sepsis or septic shock. Upon completion, the FRESH study will assess the mean difference in fluid balance at intensive care unit (ICU) discharge and associated patient outcomes, based on a dynamic assessment of FR in septic patients with refractory hypotension in an ICU setting. Interim results are anticipated in mid-to-late 2019.
 
Cheetah Medical is a global provider of 100 percent non-invasive fluid management monitoring technologies, designed for use in critical care, operating room and emergency department settings. The CHEETAH Starling SV is fast becoming the gold standard in fluid management, as it provides immediate, dynamic assessments of fluid responsiveness, enabling clinicians to make more confident and informed treatment for their patients. Moreover, recent research from the University of Kansas Medical Center has shown effective fluid management can reduce hospital ICU stays by an average of 2.89 days, reduce risk of mechanical ventilation and initiation of acute dialysis, saving over $14,000 in medical costs per patient. The company’s fluid management systems currently make an impact in more than 400 hospitals throughout the United States and in 30 countries worldwide.