Hemorrhagic ShockNCT07817966
Inferior Vena Cava Versus Subclavian Vein Collapsibility for Predicting Fluid Responsiveness in Trauma Hemorrhagic Shock
An observational study of Hemorrhagic Shock and Trauma, run by Assiut University.
Trial summary
Hemorrhagic shock from severe bleeding is a leading cause of preventable death in trauma patients. Intravenous (IV) fluid resuscitation is essential for stabilizing blood pressure and organ perfusion, but administering too much or too little fluid can cause severe complications. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hemorrhagic Shock, Trauma, Hypovolemia
- Type of treatment
- Injection or infusion
- How many people
- 120 participants
- Where
- No sites listed yet
- Study dates
- Oct 2026to Nov 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: Adult trauma patients aged 18 years or older presenting with blunt or penetrating trauma and clinical evidence of hemorrhagic shock (systolic blood pressure < 90 mmHg, mean arterial pressure < 65 mmHg, or clinical signs of tissue hypoperfusion) to the Emergency Department of Assiut University Trauma and Emergency Hospital within 6 hours of injury.
Who may be able to join
- Adult patients aged 18 years or older.
- Presentation with blunt or penetrating trauma.
- Clinical evidence of hemorrhagic shock, defined by hypotension (systolic blood pressure < 90 mmHg or mean arterial pressure < 65 mmHg), tachycardia, or other clinical signs of tissue hypoperfusion requiring fluid resuscitation.
- Spontaneously breathing patients.
- Presentation to the Emergency Department within 6 hours of injury.
- Feasibility of bedside point-of-care ultrasound examination prior to the initiation of definitive resuscitation.
Who cannot join
- Age younger than 18 years.
- Pregnancy.
- Requirement for immediate endotracheal intubation and mechanical ventilation prior to ultrasound assessment.
- Obstructive shock due to cardiac tamponade, tension pneumothorax, or other known causes.
- Known severe heart failure with left ventricular ejection fraction (LVEF) < 40%.
- Significant tricuspid regurgitation or known pulmonary hypertension that may affect systemic venous measurements.
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- Major neck or clavicular trauma preventing adequate subclavian vein ultrasound acquisition.
- Extensive abdominal trauma, morbid obesity, or other conditions precluding adequate inferior vena cava (IVC) acoustic visualization.
- Transfer from another facility after receiving large-volume fluid resuscitation (> 1 L of crystalloids or blood products prior to assessment).
- Inability or refusal to provide informed consent by the patient or their legally authorized representative.
About this study
Official title: Comparison of Inferior Vena Cava Versus Subclavian Vein Collapsibility Indices for Prediction of Fluid Responsiveness in Adult Trauma Patients Presenting With Hemorrhagic Shock: A Prospective Comparative Cohort Study
Hemorrhagic shock from severe bleeding is a leading cause of preventable death in trauma patients. Intravenous (IV) fluid resuscitation is essential for stabilizing blood pressure and organ perfusion, but administering too much or too little fluid can cause severe complications. Only about half of hemodynamically unstable patients show an increase in cardiac output after receiving fluids. Emergency physicians often use bedside ultrasound to measure respiratory changes in the inferior vena cava (IVC), known as the IVC collapsibility index (IVC-CI), to predict whether a patient will benefit from fluids. However, obtaining clear IVC views can be difficult or impossible in trauma patients due to abdominal pain, obesity, or abdominal injuries. Evaluating the subclavian vein (SCV) under the collarbone provides a potential alternative window.
The main purpose of this study is to compare the diagnostic accuracy of the subclavian vein collapsibility index (SCV-CI) against the inferior vena cava collapsibility index (IVC-CI) for predicting fluid responsiveness in adult trauma patients presenting with hemorrhagic shock.
Eligible adult trauma patients with hemorrhagic shock will undergo rapid bedside point-of-care ultrasound upon presentation to the emergency department. Physicians will measure respiratory diameter variations in both the subclavian vein and inferior vena cava. Patients will then receive a standardized fluid challenge of 10 mL/kg intravenous balanced crystalloid solution over 10 to 15 minutes as part of resuscitation. Fluid responsiveness will be assessed by measuring changes in blood flow through the neck using carotid artery Doppler ultrasound before and 5 to 10 minutes after the fluid challenge. The study will determine whether subclavian vein ultrasound offers comparable diagnostic performance and greater feasibility compared to inferior vena cava ultrasound in emergency trauma resuscitation.
- Conditions
- Hemorrhagic Shock, Trauma, Hypovolemia, Fluid Responsiveness
- Keywords
- Inferior Vena Cava Collapsibility Index, Subclavian Vein Collapsibility Index, Point-of-Care Ultrasound, POCUS, Carotid Velocity Time Integral, Fluid Resuscitation, Hemodynamic Monitoring, Shock Index
- Medical subject headings
- Shock, Hemorrhagic, Wounds and Injuries, Hypovolemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Adult Trauma Patients with Hemorrhagic Shock | Spontaneously breathing adult trauma patients (aged ≥ 18 years) presenting to the Emergency Department within 6 hours of blunt or penetrating injury with clinical evidence of hemorrhagic shock (SBP < 90 mmHg or MAP < 65 mmHg, tachycardia, or tissue hypoperfusion). All enrolled participants undergo baseline point-of-care ultrasound examination to measure both the inferior vena cava collapsibility index (IVC-CI) and subclavian vein collapsibility index (SCV-CI), in addition to carotid artery velocity time integral (Carotid VTI). Following baseline ultrasound, participants receive a standardized fluid challenge of 10 mL/kg intravenous balanced crystalloid over 10-15 minutes. Carotid VTI is remeasured within 5-10 minutes post-infusion to evaluate fluid responsiveness (defined as a Carotid VTI increase ≥ 15%). |
What is being measured
The primary outcome is the main question the study is designed to answer.
Area Under the Receiver Operating Characteristic Curve (AUC) of Subclavian Vein Collapsibility Index (SCV-CI)
The area under the receiver operating characteristic curve (AUC-ROC) will be calculated to determine the diagnostic accuracy of baseline SCV-CI for predicting fluid responsiveness. Fluid responsiveness is defined as an increase of ≥ 15% in carotid artery velocity time integral (Carotid VTI) following a 10 mL/kg crystalloid bolus. AUC values range from 0.5 (no discriminative ability) to 1.0 (perfect diagnostic accuracy).
Measured: 10 minutes post-fluid challenge
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Sep 2026
- Study startOct 2026 (estimated)
- Primary completionOct 2027 (estimated)
- Study completionNov 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hemorrhagic ShockStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 120 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Basant Saody Hashem, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07817966
- Sponsor's protocol ID
- IVC vs SCV for Fluid Response
- Status last verified
- Sep 2026
- First submitted
- 9 Sep 2026
- Last updated
- 14 Sep 2026
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Inferior Vena Cava Versus Subclavian Vein Collapsibility Indices for Prediction of Fluid Responsiveness in Adult Trauma Patients Presenting With Hemorrhagic Shock: A Prospective Comparative Cohort Study
- ClinicalTrials.gov ID
- NCT07817966
- Acronym / sponsor ID
- IVC vs SCV for Fluid Response
- Conditions
- Hemorrhagic Shock, Trauma, Hypovolemia, Fluid Responsiveness
- Keywords
- Inferior Vena Cava Collapsibility Index, Subclavian Vein Collapsibility Index, Point-of-Care Ultrasound, POCUS, Carotid Velocity Time Integral, Fluid Resuscitation, Hemodynamic Monitoring, Shock Index
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 120 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- Oct 2026 (estimated)
- Primary completion
- Oct 2027 (estimated)
- Study completion
- Nov 2027 (estimated)
- First posted
- 14 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hemorrhagic shock from severe bleeding is a leading cause of preventable death in trauma patients. Intravenous (IV) fluid resuscitation is essential for stabilizing blood pressure and organ perfusion, but administering too much or too little fluid can cause severe complications. Only about half of hemodynamically unstable patients show an increase in cardiac output after receiving fluids. Emergency physicians often use bedside ultrasound to measure respiratory changes in the inferior vena cava (IVC), known as the IVC collapsibility index (IVC-CI), to predict whether a patient will benefit from fluids. However, obtaining clear IVC views can be difficult or impossible in trauma patients due to abdominal pain, obesity, or abdominal injuries. Evaluating the subclavian vein (SCV) under the collarbone provides a potential alternative window.
The main purpose of this study is to compare the diagnostic accuracy of the subclavian vein collapsibility index (SCV-CI) against the inferior vena cava collapsibility index (IVC-CI) for predicting fluid responsiveness in adult trauma patients presenting with hemorrhagic shock.
Eligible adult trauma patients with hemorrhagic shock will undergo rapid bedside point-of-care ultrasound upon presentation to the emergency department. Physicians will measure respiratory diameter variations in both the subclavian vein and inferior vena cava. Patients will then receive a standardized fluid challenge of 10 mL/kg intravenous balanced crystalloid solution over 10 to 15 minutes as part of resuscitation. Fluid responsiveness will be assessed by measuring changes in blood flow through the neck using carotid artery Doppler ultrasound before and 5 to 10 minutes after the fluid challenge. The study will determine whether subclavian vein ultrasound offers comparable diagnostic performance and greater feasibility compared to inferior vena cava ultrasound in emergency trauma resuscitation.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Adult Trauma Patients with Hemorrhagic Shock | – | –Spontaneously breathing adult trauma patients (aged ≥ 18 years) presenting to the Emergency Department within 6 hours of blunt or penetrating injury with clinical evidence of hemorrhagic shock (SBP < 90 mmHg or MAP < 65 mmHg, tachycardia, or tissue hypoperfusion). All enrolled participants undergo baseline point-of-care ultrasound examination to measure both the inferior vena cava collapsibility index (IVC-CI) and subclavian vein collapsibility index (SCV-CI), in addition to carotid artery velocity time integral (Carotid VTI). Following baseline ultrasound, participants receive a standardized fluid challenge of 10 mL/kg intravenous balanced crystalloid over 10-15 minutes. Carotid VTI is remeasured within 5-10 minutes post-infusion to evaluate fluid responsiveness (defined as a Carotid VTI increase ≥ 15%). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- Adult trauma patients aged 18 years or older presenting with blunt or penetrating trauma and clinical evidence of hemorrhagic shock (systolic blood pressure < 90 mmHg, mean arterial pressure < 65 mmHg, or clinical signs of tissue hypoperfusion) to the Emergency Department of Assiut University Trauma and Emergency Hospital within 6 hours of injury.
Key inclusion criteria (6 listed)
- Adult patients aged 18 years or older.
- Presentation with blunt or penetrating trauma.
- Clinical evidence of hemorrhagic shock, defined by hypotension (systolic blood pressure < 90 mmHg or mean arterial pressure < 65 mmHg), tachycardia, or other clinical signs of tissue hypoperfusion requiring fluid resuscitation.
- Spontaneously breathing patients.
- Presentation to the Emergency Department within 6 hours of injury.
Key exclusion criteria (10 listed)
- Age younger than 18 years.
- Pregnancy.
- Requirement for immediate endotracheal intubation and mechanical ventilation prior to ultrasound assessment.
- Obstructive shock due to cardiac tamponade, tension pneumothorax, or other known causes.
- Known severe heart failure with left ventricular ejection fraction (LVEF) < 40%.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Area Under the Receiver Operating Characteristic Curve (AUC) of Subclavian Vein Collapsibility Index (SCV-CI)
Time frame: 10 minutes post-fluid challenge
The area under the receiver operating characteristic curve (AUC-ROC) will be calculated to determine the diagnostic accuracy of baseline SCV-CI for predicting fluid responsiveness. Fluid responsiveness is defined as an increase of ≥ 15% in carotid artery velocity time integral (Carotid VTI) following a 10 mL/kg crystalloid bolus. AUC values range from 0.5 (no discriminative ability) to 1.0 (perfect diagnostic accuracy).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Sep 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Hemorrhagic Shock and Trauma, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 14 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Area Under the Receiver Operating Characteristic Curve (AUC) of Subclavian Vein Collapsibility Index (SCV-CI) (time frame: 10 minutes post-fluid challenge). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Sep 2026.