Project: Personalised perfusion guided fluid therapy

Acronym	PerFluid (Reference Number: ERAPERMED2021-250)
Duration	01/08/2022 - 01/08/2025
Project Topic	Background: Acute circulatory failure (ACF) and shock occur when the heart and circulation cannot provide organs metabolic and functional needs, and affects ~30% of intensive care unit (ICU) patients. Fluid resuscitation is the primary treatment, but fails ~50% of the time due to lack of a clinically feasible, non-invasive perfusion metric to assess fluid responsiveness, with failed efforts negatively affecting patient outcome, length of stay, and cost. Hypothesis: Model-based stressed blood volume (SBV) can provide a clinically effective and feasible, non-invasive measure of perfusion and fluid responsiveness in ACF/shock patients. Rationale: The real issue is perfusion or SBV is a function of: 1) cardiac output and/or arterial pressure; 2) arterial elastance; 3) systemic resistance; and 4) central venous pressure. Standard clinical metrics using just one of these fail in practice. However, SBV directly accounts for all these metrics, every heartbeat. Primary Impact: A novel, non-invasive model-based measurement accounting for major confounding affects in assessing perfusion and fluid responsiveness. Methodology: We recently developed the first model-based measure of SBV, and validated its use assessing fluid responsiveness in animal trials, but it lacks proof in humans. 1. Non-invasive: Unique 10,000 patient database from NZ partner used to develop accurate estimates of central pressures from clinically available radial/femoral artery pressures. 2. Retrospective Validation: Use of independent patients and clinical data in this dataset to assess SBV as a fluid responsiveness metric. 3. Pilot Validation: Pilot intervention trial (N=10 patients) testing results of Steps 1-2 under informed consent 4. Impact: assess ergonomic and economic impacts during and after Step 3 using hospital data and surveys on ease of use. Partnership: Multidisciplinary collaboration of discipline leaders with unique capabilities and datasets to enable this research.
Network	ERA PerMed
Call	4th Joint Transnational Call for Proposals (2021)

Project partner

Number	Name	Role	Country
1	University of Liège	Coordinator	Belgium
2	University of Canterbury	Partner	other
3	Budapest University of Technology and Economics	Partner	Hungary
4	Furtwangen university	Partner	Germany
5	Semmelweis university	Partner	Hungary