Hemodynamic Optimisation Guided With Transcranial Doppler in Septic Shock
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Trans Cranial Doppler Ultrasonography in Heamodynamic Optimisation in Septic Shock
- Sponsor
- Mongi Slim Hospital
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- mortality at day 28
- Last Updated
- 5 years ago
Overview
Brief Summary
Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase.
patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses:
- Group 1: standard hemodynamic goals and catecholamin infusion to achieve: mean arterial pressure > or equal to 65 mmHg and diastolic arterial pressure > ou equal to 50 mmHg within the first 60 minutes.
- Group 2: personalized hemodynamic goals and catecholamin infusion until normal transcranial doppler: IP<1,2.
Detailed Description
Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase. patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses: * Group 1: standard hemodynamic goals and cathecolamin infusion to achieve: mean arterial pressure \> or equal to 65 mmHg and diastolic arterial pressure \> ou equal to 50 mmHg within the first 60 minutes. * Group 2: personalized hemodynamic goals and cathecolamin infusion until normal transcranial doppler: IP\<1,2. For the 2 groups, standard management including: microbiological sampling, early broad spectrum anti infective therapy, fluid management and decreasing of blood lactate levels, will be aimed within the first 60 minutes. For the Group 2 patients: personalized hemodynamic management will be maintained during 72 hours.
Investigators
Mhamed Sami Mebazaa
Professor head of the anesthesia and intensive care department
Mongi Slim Hospital
Eligibility Criteria
Inclusion Criteria
- •All ICU patients presenting septic shock
- •No criteria of traumatic or vascular brain injury
Exclusion Criteria
- •Patients with refractory septick shock
- •rapid fatal evolution: before 72 hours
- •No individualisation of the MCA ultrasonographic window
Outcomes
Primary Outcomes
mortality at day 28
Time Frame: 28 days after ICU admission
Mortality at day 28
Secondary Outcomes
- Incidence of sepsis associated encephalopathy(28 days after ICU admission)
- Incidence of sepsis related organ failures(28 days after ICU admission)
- Length of ICU stay(30 days after end of randomization)