Patients who suspected sepsis with hyperlactatemia in Emergency department of Srinagarind hospital, Khon Kaen university, Khon Kaen Thailand Hyperlactatemia, critically ill patient, sepsis
Conditions
Interventions
-Administer 30 mL/kg of actual BW intravenous fluid bolus within the first 3 hours, and followed rate of intravenous fluid as maintenance rate by Holiday and Segar s laws at least 24 hours after rando
Fluid bolus arm,Conventional fluid protocol
Sponsors
Khon Kaen University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1) Patients who suspected sepsis: SIRS criteria > or = 2 points + suspected or confirmed source of infection. 2) Hyperlactatemia: Point-of-care serum lactate 2-4 mmol/L from arterial or venous blood gas. 3) Ages over or equal 18 years old.
Exclusion criteria
Exclusion criteria: 1) Congestive heart failure or sign of volume overload or patient who had past history of low ejection fraction (%EF less than 40%) or Functional class IV 2) ESRD with and without RRT 3) Hypotension due to any cause (SBP < 90 mmHg or MAP < 65 mmHg) 4) Morbid obesity (BMI > or = 40 kg/m2) 5) Pregnancy 6) Transferred from another hospital 7) Administration of IV fluid before ED arrival 8) Refused to participate or DNR 9) Suspected type B lactic acidosis e.g., toxin-induced (metformin, isoniazid, NRTIs), liver failure or thiamine deficiency
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| New onset of hypotension within 24 hours after randomization 28 days or until discharge from hospital mean | — |
Secondary
| Measure | Time frame |
|---|---|
| Lactate clearance 6 hours after randomization mean,Change in SOFA score 72 hour after randomization mean,Vasopressor use 28 days or until hospital discharge N%,Vasopressor free day 28 days after randomization mean,New organ failure within 1st weeks after randomization mean,Organ failure free day 28 days after randomization mean,Renal replacement therapy 28 days or until hospital discharge N%,Renal replacement therapy free day 28 days after randomization mean,Mortality rate day 28 after randomization N% | — |
Countries
Thailand
Contacts
Public Contactteeraporn chayawuttipong
Faculty of Medicine, Khon Kaen University
Outcome results
None listed