Septic Shock
Conditions
Keywords
sepsis, septic shock, hemodynamic, echocardiogram
Brief summary
The goal of this observational study is to learn about the change of hemodynamic response from intravenous fluid versus medical (vasopressor) resuscitation by echocardiogram in septic shock patient. The main question it aims to answer is: How hemodynamic response change from intravenous fluid versus medical (vasopressor) resuscitation by echocardiogram in septic shock patient? Participants already receiving the appropriate resuscitation at that time by their medical staff as part of their regular medical care for septic shock. The echocardiogram will assess before and after resuscitation.
Detailed description
The goal of this observational study is to learn about the change of hemodynamic response from intravenous fluid versus medical (vasopressor) resuscitation by echocardiogram in septic shock patient. The investigators enrolled septic shock patients, who required hemodynamic resuscitation. Then the investigators performed baseline echocardiogram to measured stroke volume, cardiac output and E/Ea before start resuscitation. In fluid resuscitation group, patient will received either fluid resuscitation about 200 mL to 500 mL before preformed echo after fluid resuscitation. In vasopressor group, patient will received norepinephrine titration dose about 0.05 mcg/kg/min, before performed echocardiogram. Then the investigators compare the different change between those resuscitation with fluid and with vasopressor titration, in term of stroke volume, cardiac output, cardiac index and E/Ea change.
Interventions
DIAGNOSTIC_TESTEchocardiogram
Patient will be undergone echocardiogram for hemodynamic evaluation, before and after resuscitation by fluid and by vasopressor
Sponsors
Mahidol University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients aged ≥18 years * Diagnosis with Septic Shock (Sepsis-3 Definition of Septic Shock) * Hypotension, SBP \< 90 mmHg, or mean arterial BP \< 65 mmHg
Exclusion criteria
* Patients who receive two or more vasopressors * Patients who receive inotropic medications * Patients who receive simultaneously fluid with vasopressor resuscitation * Patients with insufficiently quality ultrasound images for determining echocardiography * Patients or their legally authorized representatives (LAR), who decline participation in the study or are unable to provide informed consent before enrollment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cardiac Index | T0 = Cardiac index before resuscitation T1= Cardiac index 15minutes after resuscitation by IV fluid or Vasopressor (Post-resuscitation) | Change of Cardiac Index from pre-to-post resuscitation * Cardiac index before resuscitation * Cardiac index 15minutes after resuscitation by IV fluid or Vasopressor (Post-resuscitation) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of other echocardiographic parameter from baseline to post-resuscitation. | T0 = Echocardiographic parameters before resuscitation T1= Echocardiographic parameters 15minutes after resuscitation by IV fluid or Vasopressor (Post-resuscitation) | Change in other echocardiographic parameter; IVC variation, Left ventricular ejection fraction, Left ventricular diastolic function in form of E/A ratio and E/E' ratio; from baseline to post-resuscitation; Fluid resuscitation vs Vasopressor Resuscitation and its correlation with clinical parameters below |
| 28-day Mortality | 28 days | death outcome |
Countries
Thailand
Contacts
CONTACTSurat Tongyoo, MD
PRINCIPAL_INVESTIGATORSurat Tongyoo, MD
Siriraj Hospital
Outcome results
None listed