Microcirculatory Guided Goal Directed Fluid Therapy in Septic Shock; a Feasibility Study
Overview
- Phase
- Not Applicable
- Intervention
- Intra venous fluid
- Conditions
- Septic Shock
- Sponsor
- King's College London
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Time to acquire POEM score
- Last Updated
- 7 years ago
Overview
Brief Summary
Prospective single centre study to assess the feasibility of fluid resuscitation guided by macrocirculatory and microcirculation parameters in patients in the early stages of septic shock. The investigators will utilise a novel point of care tool to assess microcirculatory sublingual perfusion in patients with septic shock. This, in combination with conventional haemodynamic monitoring will determine the timing and volume of resuscitative fluid administration. The feasibility of this technique will be determined prior to embarking on a pilot RCT.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \> 18 years Within 6 hours of ICU admission Evidence of suspected or confirmed infection Serial Organ Failure Assessment (SOFA) score increase of 2 or more (assuming baseline 0 if no previous measures) Requiring vasopressor therapy to maintain a MAP \> 65mmHg Lactate \> 2 mmol/l despite initial fluid resuscitation Requirement for advanced haemodynamic monitoring (PiCCO system) in the opinion of the attending clinician
Exclusion Criteria
- •Patients not expected to survive 24 h in whom the intent of treatment is palliative Patients in whom the primary cause of the shock state is cardiogenic
Arms & Interventions
GDT feasibility
Patients undergoing microcirculatory goal directed therapy
Intervention: Intra venous fluid
Outcomes
Primary Outcomes
Time to acquire POEM score
Time Frame: 6 hours
Feasibility measure of point of care test
Effect of POEM score on clinical decision making
Time Frame: 6 hours
Feasibility outcome measure