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临床试验/ISRCTN36307479
ISRCTN36307479已完成未知

A multicentre, randomised controlled trial of the clinical and cost-effectiveness of early, goal-directed, protocolised resuscitation for emerging septic shock

Intensive Care National Audit and Research Centre (ICNARC) (UK)0 个研究点目标入组 1,260 人开始时间: 2009年11月19日最近更新:
适应症

试验速览

阶段
未知
状态
已完成
发起方
入组人数
1,260

研究概览

简要总结

暂无简介。

研究设计

研究类型
Interventional

入排标准

性别
All

入选标准

  • 1. Greater than or equal to 18 years of age, either sex
  • 2. Known or presumed infection
  • 3. Two or more systemic inflammatory response syndrome (SIRS) criteria:
  • 3.1. Core temperature less than or equal to 36°C or greater than or equal to 38°C
  • 3.2. Heart rate greater than or equal to 90 beats/min
  • 3.3. Respiratory rate greater than or equal to 20 breaths/min (or hyperventilation indicated by partial pressure of carbon dioxide in arterial blood [PaCO2] 4.3 kPa or mechanical ventilation for an acute process)
  • 3.4. White blood cell count less than or equal to 4 x 10^9 l or greater than or equal to 12 x 10^9 l (or the presence of greater than 10% immature neutrophils bands)
  • 4. Refractory hypotension or hypoperfusion:
  • 4.1. Hypotension is confirmed by the presence of systolic blood pressure less than 90 mmHg despite an intravenous (IV) fluid challenge of at least 20 ml/kg within 30 minutes of Emergency Department (ED) arrival (including IV fluids administered by pre-hospital/Emergency Medical Services [EMS] personnel)
  • 4.2. Hypoperfusion is confirmed by a blood lactate concentration greater than or equal to 4 mmol/L)
  • 5. First dose of IV antimicrobial therapy commenced prior to randomisation

排除标准

  • Current exclusion criteria as of 04/01/2013:
  • 1. Age less than 18 years
  • 2. Known pregnancy
  • 3. Primary diagnosis of:
  • 3.1. an acute cerebral vascular event
  • 3.2. acute coronary syndrome
  • 3.3. acute pulmonary oedema
  • 3.4. status asthmaticus
  • 3.5. major cardiac arrhythmia (as part of primary diagnosis)
  • 3.6. seizure
  • 3.7. drug overdose
  • 3.8. injury from burn or trauma
  • 4. Haemodynamic instability due to active gastrointestinal haemorrhage
  • 5. Requirement for immediate surgery
  • 6. Known history of AIDS
  • 7. Do-Not-Attempt-Resuscitation (DNAR) status
  • 8. Advanced directives restricting implementation of the resuscitation protocol
  • 9. Contraindication to central venous catheterization
  • 10. Contraindication to blood transfusion
  • 11. Attending clinician deems aggressive resuscitation unsuitable
  • 12. Transferred from another in-hospital setting
  • 13. Not able to commence resuscitation protocol within one hour of randomisation or complete six hours of protocol treatment from commencement
  • Previous exclusion criteria until 04/01/2013:
  • 1. Aged less than 18 years
  • 2. Known pregnancy
  • 3. Primary diagnosis of acute cerebral vascular event, acute coronary syndrome, acute pulmonary oedema, status asthmaticus, major cardiac arrhythmia (as part of primary diagnosis), seizure, drug overdose, injury from burn or trauma
  • 4. Haemodynamic instability due to active gastrointestinal (GI) haemorrhage
  • 5. Immunosuppressive agents including chemotherapy for uncured cancer, immunosuppression for organ transplantation or from systematic disease
  • 6. Requirement for immediate surgery
  • 7. Do not resuscitate status
  • 8. Advanced directives restricting implementation of the protocol
  • 9. Contraindications to central venous catheterisation
  • 10. Contradiction to blood transfusion (i.e. Jehovah's Witness)
  • 11. Attending physician deems aggressive care unsuitable
  • 12. Participation in another interventional study
  • 13. Transferred from another in-hospital setting
  • 14. Not able to start within 1 hour of randomisation or finish within 6 hours

研究者

发起方
Intensive Care National Audit and Research Centre (ICNARC) (UK)

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