Impact of Starting Dose of Vasopressor on Hemodynamic Response in Shock
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 120
- 主要终点
- Mean arterial blood pressure
研究概览
简要总结
This study is designed to assess the effect of initial vasopressor dose on clinical outcomes. To date, there are no clinical guidelines or recommendations regarding the dose of vasopressor medication that should be initiated before titrating to a mean arterial pressure (MAP) in patients with circulatory shock. High heterogeneity and clinical equipoise regarding this variable exist in routine clinical practice. However, there is strong evidence that delays in achieving MAP goals lead to worse clinical outcomes. The study will randomize patients with circulatory shock to a low (5mcg/min of norepinephrine) or high (15mcg/min of norepinephrine) initial starting dose followed by the usual protocolized titration to MAP goal. The time to reach the goal MAP, organ dysfunction, hospital length of stay, and mortality will be measured for each group.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients at least 18 years old
- •Patients who are diagnosed with shock (MAP < 65 mmHg) require the initiation of vasopressors
- •Care provided in the ED or admission to the Medical Intensive Care Unit (MICU)
- •Norepinephrine chosen as first-line vasopressor by the treating clinician
排除标准
- •Patients who are receiving vasopressors or inotropes prior to UI Health hospital presentation/admission
- •Baseline MAP >/= 65 mmHg
- •Pregnant patients (checked as standard of care on admission)
- •Prisoners.
- •Immediate post-cardiac arrest patients
结局指标
主要结局
Mean arterial blood pressure
时间窗: During first shock episode, up to 28 days of shock episode.
Time to achieve and sustain a mean arterial pressor greater than or equal to 65 mmHg
次要结局
未报告次要终点
研究者
Scott Benken
Clinical Associate Professor
University of Illinois at Chicago