A pilot multicenter randomized controlled trial comparing an approach of individualized blood pressure targets to standard care among critically ill patients with shock

Intensive Care Unit, John Hunter Hospital0 个研究点目标入组 50 人开始时间: 2018年4月13日最近更新: 2022年8月15日

试验速览

暂无简介。

•ICU patients aged greater than or equal to 40 years
•The patient is deemed to be in shock, defined as clinician-initiated vasopressor therapy AND supported by any of the following within the last 24 hours:
•oLactate level greater than or equal to 2 mmol/l or base deficit greater than or equal to 3 mmol/l,
•oUrine output less than or equal to 0.5 ml/kg/h or <40 ml/h for 2 or more consecutive hours
•oRespiratory rate >22 per minute
•oAltered mentation (Glasgow Coma Score <14)

•Patients who are moribund, or have documented not-for-resuscitation orders
•At least 24 hours have lapsed from the time of initiation of vasopressor or inotropic support
•Patients who are either receiving or are deemed to imminently need renal replacement therapy.
•Patients who already have an increase in serum creatinine of >350 µmol/l from baseline.
•End stage renal disease
•Patients where trauma is the main reason for the current ICU admission.
•Pregnancy, if known
•Active bleeding (clinical suspicion or >2 packed red blood cells within 24 hours)
•Insufficient (less than two) pre-morbid BP readings are available.
•Patients on extracorporeal support (ECMO, IABP, VAD).
•Potential contraindications to either higher or lower BP targets (including but not limited to)
•oCerebral perfusion pressure guided therapy e.g. intracranial hemorrhage or subarachnoid hemorrhage or traumatic brain injury
•oAbdominal perfusion pressure guided therapy
•oAortic injury (e.g. dissection or post-operative)
•oPost cardiac surgery
•oAny other condition requiring higher or lower BP target specifically

发起方

Intensive Care Unit, John Hunter Hospital