The study will include patients with septic shock hospitalized in the intensive care unit.. Severe sepsis with septic shock
Conditions
Interventions
Intervention 1: In the intervention group dose adjustment will be done by monitoring the perfusion index through the MASIMO prop pulse oximeter in the Alborz B9 Saadat monitor
In this group, the researcher will reduce the dose of norepinephrine drug in the control group by 1 µ/min through the infusion pump every 20 minutes for 8 hours in order to maintain the minimum dose o
Sponsors
Mashhad University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Inclusion criteria include the diagnosis of septic shock in patients by special care specialist and based on the latest SSC guidelines, including serum lactate more than 2 mmol/L and the need for norepinephrine infusion to create MAP=65 mm Hg after initial fluid resuscitation. It is with the possibility of infection. Age 18 years and older obtaining informed consent temperature greater than 36 degrees Celsius SOFA index greater than and equal to 2 the maximum time interval from the start of norepinephrine infusion to the start of the intervention should be 4 hours.
Exclusion criteria
Exclusion criteria: need for dialysis impaired detection of PI by sensors active bleeding arrhythmias affecting hemodynamics during intervention. history of cardiac and pulmonary resuscitation active hematological malignancy ESRD class B and C liver failure peripheral vascular diseases in the upper limbs
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Creatinine level measurement. Timepoint: at the beginning of the study (T=0) and 8 hours after the start of the study (T=8h). Method of measurement: Blood sample.;Lactate level measurement. Timepoint: at the beginning of the study (T=0) and 8 hours after the start of the study (T=8h). Method of measurement: Blood sample.;SVO2 (Mixed venous oxygen saturation). Timepoint: at the beginning of the study (T=0) and 8 hours after the start of the study (T=8h). Method of measurement: Blood sample.;O2ER(Oxygen extraction ratio). Timepoint: at the beginning of the study (T=0) and 8 hours after the start of the study (T=8h). Method of measurement: Blood sample.;CRT(Capillary Refill Time). Timepoint: at the beginning of the study (T=0) and 8 hours after the start of the study (T=8h). Method of measurement: Pressure on the finger for 15 seconds and measuring the capillary return time using a Chronometer.;The total dose of norepinephrine. Timepoint: 8 hours after the start of the study (T=8h). Method of measurement: Use of hemodynamic data recording chart.;The amount of intravenous fluids received. Timepoint: 8 hours after the start of the study (T=8h). Method of measurement: Using intake and output information recording chart.;Urinary output. Timepoint: 8 hours after the start of the study (T=8h). Method of measurement: Using intake and output information recording chart.;Occurrence of dysrhythmias. Timepoint: Whenever it occurs during the study, it will be recorded and checked 8 hours after the start of the study (T=8h). Method of measurement: It will be observed, monitored and recorded by the researcher. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactNegin Akbari
Mashhad University of Medical Sciences
Outcome results
None listed