Haemorrhagic Shock, Variceal Hemorrhage
Conditions
Keywords
microcirculation, octreotide, norepinephrine, Variceal Hemorrhage, Haemorrhagic Shock
Brief summary
Octreotide is used to decrease portal pressure of cirrhotic patients admitted for variceal bleeding. When patients are in haemorrhagic shock, the recommended drug to increase arterial pressure is norepinephrine. Microcirculatory effects of octreotide when it is added to noradrenaline has not been investigated yet. The aim of the study is to evaluate the effect of octreotide plus norepinephrine for patient with haemorrhagic shock after variceal bleeding.
Interventions
Patients admitted in intensive care unit after variceal hemorrhage treated with norepinephrine perfusion will received an additional octreotide perfusion during one hour.
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients more than 18 years old * patient with liver cirrhosis * patient with haemorrhagic shock due to variceal bleeding * patient with an arterial blood pressure less than 65 mmHg despite * patient able to express consent * signed written informed consent form * patient covered by national health insurance
Exclusion criteria
* patient less than 18 years old * patient non covered by national health insurance * pregnant or breast feeding patent * known octreotide allergy * cardiac arrest because of shock * refused consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline of microcirculatory flow index | one hour after octreotide perfusion | microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| heart rate | before and one hour after octreotide perfusion | heart rate |
| percentage of perfused vessels | before and one hour after octreotide perfusion | percentage of perfused vessels will be measured with sidestream dark field handheld microscope |
| functional capillary density | before and one hour after octreotide perfusion | functional capillary density will be measured with sidestream dark field handheld microscope |
| Mean arterial pressure | before and one hour after octreotide perfusion | Mean arterial pressure |
| ejection fraction | before and one hour after octreotide perfusion | ejection fraction |
Countries
France
Outcome results
None listed