Health Condition 1: O- Medical and Surgical
Conditions
Interventions
Intervention1: Group A: Vasopressin discontinued first, followed by norepinephrine.
: Baseline data will be collected before the discontinuation of any vasopressor, including
demographic information
Sponsors
Somya Sharma
Eligibility
Inclusion criteria
Inclusion criteria: Adult patients (more than or equal to 18 years) admitted to the ICU with a diagnosis of septic shock based on Sepsis-3 criteria. Treated with both norepinephrine and vasopressin for at least 12 hours. Achieved hemodynamic stability (MAP more than or equal to 65 mmHg) with stable or decreasing vasopressor requirements. All patients on invasive hemodynamic monitoring.
Exclusion criteria
Exclusion criteria: Patients or legally authorized representative refusing consent Use of additional vasopressors for example epinephrine dopamine Hemodynamic instability requiring escalation at the time of weaning Severe cardiac arrhythmias including ventricular fibrillation ventricular tachycardia paroxysmal supraventricular tachycardia second degree heart block third degree heart block complete heart block atrial fibrillation causing instability Cardiogenic shock Advanced liver failure Left ventricular ejection fraction less than 45 percent on bedside echocardiography Pregnant or lactating women Any patient or their legally authorized representative who withdraws consent at any time during the conduct of the study will not be included in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To compare the incidence of hypotension following the discontinuation of norepinephrine first versus vasopressin first in adult patients recovering from septic shock.Timepoint: After the first vasopressor is discontinued hemodynamic parameters such as MAP heart rate respiratory rate and SpO2 will be measured at multiple time points just before discontinuation T0 one hour after discontinuation T1 three hours T3 and six hours T6 | — |
Secondary
| Measure | Time frame |
|---|---|
| To evaluate the need for re initiation or escalation of vasopressor therapy post discontinuation To compare incidence of acute kidney injury in both groups post discontinuation To compare the intensive care unit length of stay between patients in the two discontinuation arms Timepoint: After the first vasopressor is discontinued hemodynamic parameters such as MAP heart rate respiratory rate and SpO2 will be measured at multiple time points just before discontinuation T0 one hour after discontinuation T1 three hours T3 and six hours T6 | — |
Countries
India
Contacts
Public ContactAkash Ray Mohapatra
Armed forces medical college
Outcome results
None listed