Sepsis
Conditions
Brief summary
To investigate the relationship between initial ClearSight™ derived hemodynamic parameters and outcomes (death, ongoing organ dysfunction or delayed ICU admission) in patients with acute infection and possible sepsis, with a focus on venous blood lactate (\< 2.0, 2.0-3.9, and ≥ 4.0 mmol/dL) and hemodynamic subgroups, using ED patients presenting with minor infections or asthma/COPD exacerbations as controls (henceforth referred to as Sepsis Mimic Group).
Interventions
DEVICEClearSight™ / EV1000NI Clinical Platform
Noninvasive Hemodynamic Monitoring utilizing ClearSight TM System
Sponsors
Edwards Lifesciences
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Venous Blood Lactate Groups Inclusion Criteria: * ≥ 18 years of age at the time of enrollment * Any combination of acute symptoms and signs that the treating ED physician, after initial history and physical examination, attributes to a systemic infection * ED Physician confirms likely hospital admission (\> 50%) due to suspicion of infection * ED Physician confirms intention to order both blood cultures and venous blood lactate levels * Ability to enroll patient and begin ClearSight™ monitoring within three (3) hours of ED presentation
Exclusion criteria
* Initial venous blood lactate measured \> 3 hours after ED arrival * Pre-existing infection for which patient is being treated with antibiotics as an outpatient * Prisoners * Pregnant women * Any previous medical condition with life expectancy of \< 3 months (patients with ESRD and heart failure are not excluded) * DNR or comfort care order preexisting to ED visit or established in the ED * Palliative care or hospice consult in the ED * Known severe aortic insufficiency * Known history of Raynaud's disease * Poor follow-up candidate in the opinion of the Investigator * Current or planned enrollment in an investigational trial that in the opinion of the Investigator may significantly affect hemodynamic data collection. Control Sepsis Mimic Inclusion Criteria: * ≥18 years of age at the time of enrollment * Presents to the ED with a chief complaint consistent with a minor infection (upper respiratory infection, soft tissue infection, viral infection) or an asthma or COPD exacerbation on whom the treating physician is not ordering labs for blood cultures or lactate levels * Ability to enroll patient and begin ClearSight™ monitoring within three (3) hours of ED presentation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite outcome | Within 72 hours of presentation | Increase in modified Sequential Organ Failure Assessment (mSOFA) score ≥ 1 resulting in ICU admission / death. |
| Venous Blood Lactate clearance | Within 24 and 72 hours of presentation | Venous Blood Lactate clearance |
| Length of Stay | 30 days | Emergency Department length of stay, ICU length of stay, and Hospital length of stay |
| Recidivism | 30 days | Recidivism within 30 days of the index hospital visit |
Countries
United States
Contacts
Primary ContactJurandir Araujo, BA
Backup ContactRyan Zafra, BS
Outcome results
None listed