Circulatory System Cardiology
Conditions
Interventions
Conventional fluid resuscitation
Inferior Vena Cava Diameter guided fluid resuscitation
Sponsors
Menoufia University Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: All adult patients (=18 years old) with septic shock (those with persisting hypotension requiring vasopressors to maintain a mean arterial pressure of 65 mm Hg or higher and a serum lactate level greater than 2 mmol/L (18 mg/dL) despite adequate volume resuscitation) who are diagnosed in the first 6 h.
Exclusion criteria
Exclusion criteria: 1) Patients with congestive pulmonary edema or known poor systolic cardiac function (left ventricular ejection fraction = 40%). 2) Patients with known right heart pathology. 3) Patients have or are suspected of having marked ascites, significant bowel dilatation, or conditions that could cause abdominal hypertension. 4) Patients with body mass index = 30 kilograms/meters squared. 5) Patients with concomitant attack of a severe airway disease (eg, asthma or chronic obstructive pulmonary disease that may have confounded the Inferior Vena Cava (IVC) interpretation. 6) Inferior Vena Cava (IVC) could not be identified, or its diameter could not be measured correctly. 7) Patients with end-stage renal disease with or without dialysis. 8) Patients with noninfectious disease as a final diagnosis. 9) Pregnancy. 10) Patients with active hemorrhage. 11) Patients have a living will stating “do not resuscitate”. 12) Patients declined to consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The 30-day mortality outcome of patients with sepsis-induced tissue hypoperfusion (SITH) and septic shock (SS) who will be treated with Inferior Vena Cava diameter guided fluid management compared with those treated with the conventional strategy. | — |
Secondary
| Measure | Time frame |
|---|---|
| - The six-hour lactate clearance, amount of intravenous (IV) fluid, rate of vasopressor and mechanical ventilator (MV) use. - Change in sequential organ failure assessment (SOFA) score at 72 hours. - Change in Acute Physiology and Chronic Health Evaluation (APACHEII) score. -- Length of stay in ICU. | — |
Countries
Egypt
Contacts
Public ContactWessam Eldin Abd El Rahman Sultan
Faculty of Medicine. Menoufia University
Outcome results
None listed