Optimal Target Blood Pressure in Elderly with Septic Shock trial

Conditions

Septic shock

Ryuto Yokoyama, Tatsuya Hayasaka, Tadahiro Kobayashi, Kento Sakaguchi, Kazuma Yamakawa et al. (8 authors)

Journal of Anesthesia Analgesia and Critical Care2026-09-07

Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised controlled trial.

Endo A, Yamakawa K, Tagami T, Umemura Y, Wada T, Yamamoto R, Nagasawa H, Takayama W, Yagi M, Takahashi K, Kojima M, Narita C, Kazuma S, Takahashi J, Shiraishi A, Todani M, Nakane M, Nagata T, Tanaka S, Yokokawa Y, Takahashi K, Ishikita H, Hisamune R, Sasaki J, Muramatsu KI, Sonobe H, Minami K, Hoshi H, Otomo Y, OPTPRESS trial investigators.

2025-05-1315 citations

10.1007/s00134-025-07910-4

Optimal target blood pressure in elderly with septic shock (OPTPRESS) trial: study protocol for a randomized controlled trial

Akira Endo, Kazuma Yamakawa, Takashi Tagami, Yutaka Umemura, Kyosuke Takahashi et al. (30 authors)

Trials2022-09-243 citations

10.1186/s13063-022-06732-9

Optimal target blood pressure in critically ill adult patients with vasodilatory shock: A systematic review and meta-analysis.

Yoshimoto H, Fukui S, Higashio K, Endo A, Takasu A, Yamakawa K.

2022-08-1613 citations

10.3389/fphys.2022.962670

Interventions

Targeting mean arterial pressure of 80-85 mmHg during the first 72 hours after randomization Targeting mean arterial pressure of 65-70 mmHg during the first 72 hours after randomization

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Patients with septic shock who are aged 65 years or older and requires management in an intensive care unit

Exclusion criteria

Exclusion criteria: 1. Patients who are highly likely to be transferred to another hospital within 72 h of randomisation 2. Patients who have been on vasopressors for 3 or more hours 3. Patients experiencing cardiac arrest before randomisation 4. Patients who are diagnosed with coronavirus disease 2019 5. Patients who have the advanced directives restricting implementation of the standard critical care (e.g., catecholamine use, mechanical ventilation, and renal replacement therapy) 6. Patients with other diseases that require stricter blood pressure control than for maintaining haemodynamics in septic shock (uncontrollable active bleeding, aneurysms, arterial dissection, etc.) 7. Patients participating in other clinical trials that involve interventions 8. Patients who need to be arrested, detained, or put in custody by law enforcement or legal agencies 9. Patients who refuse to participate in the trial 10. Patients deemed ineligible to participate by a clinical physician.

Design outcomes

Primary

Measure	Time frame
All-cause mortality at 90 days after randomization	—

Secondary

Measure	Time frame
1. Lactate clearance at 24 hours after randomization 2. Incidence rates of adverse events (arrhythmia, thrombosis, ischemia, or hemorrhage) during the 72 hours after randomization 3. All-cause mortality rate at 28 days 4. Sepsis-related mortality at 28 days after randomization 5. Ventilator-free days at 28 days after randomization 6. Renal replacement therapy-free days at 28 days after randomization 7. Catecholamine-free days at 28 days after randomization 8. Sepsis-related mortality at 90 days after randomization	—

Measure

Time frame

1. Lactate clearance at 24 hours after randomization 2. Incidence rates of adverse events (arrhythmia, thrombosis, ischemia, or hemorrhage) during the 72 hours after randomization 3. All-cause mortality rate at 28 days 4. Sepsis-related mortality at 28 days after randomization 5. Ventilator-free days at 28 days after randomization 6. Renal replacement therapy-free days at 28 days after randomization 7. Catecholamine-free days at 28 days after randomization 8. Sepsis-related mortality at 90 days after randomization

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Countries

Japan

Contacts

Public ContactAkira Endo

Tokyo Medical and Dental University Trauma and Acute Critical Care Center

eraeaccm@tmd.ac.jp03-3813-6111

Outcome results

None listed