Septic shock Restrictive fluid management, Septic shock, Vasopressor, Fluid balance, Mortality
Conditions
Interventions
A protocol for daily fluid restriction aiming to achieve zero balance was applied. Fluid intake was restricted, including drugs, nutrition, parenteral fluid, and blood transfusions. A fluid bolus was
Experimental Procedure/Surgery,No Intervention No treatment
Protocolized fluid strategy,Usual care
Sponsors
faculty of medicine ramathibodi hospital
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged 18 to 80 2. Patients with septic shock and being invasive mechanically ventilated 3. The patient or direct family members are willing to participate in the research project and sign the consent form to join the research study.
Exclusion criteria
Exclusion criteria: 1. Patient who required fluid resuscitation 2. Patient who has received chronic RRT 3. Patient who requires maintenance fluid therapy (e.g. diabetic ketoacidosis, and non-ketotic coma) 4. Current treatment for diabetes insipidus 5. Patient who has a third space loss from severe ascites, severe burn, or bowel obstruction 6. Severe hyponatremia (Na below 125 mmol/L) or hypernatremia (Na above 155 mmol/L) 7. Patient with ongoing gastrointestinal loss (e.g. persistent diarrhea) 8. Patient with ongoing fluid loss from drainage (more than 500ml within 8 hours) 9. Pregnancy or lactation 10. Active Do Not Attempt Resuscitation order 11. Not expected to survive for 72 hours 12. Refusal of consent 13. Inability of personal consultee to understand written or verbal information and for whom no interpreter is available 14. Known allergic reaction to one or more of the study drugs 15. Inability to measure fluid balance
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cumulative fluid balance during the first 72 hours after randomization first 72 hours after randomization ml,Change in SOFA score from baseline to day 3, 5 and 7 day 3, 5 and 7 day | — |
Secondary
| Measure | Time frame |
|---|---|
| 28-day all-cause mortality in patients with septic shock 28 day day,Duration of mechanical ventilation for survivors during admission day,Major adverse kidney event at day 7: new renal replacement therapy, or persistent renal dysfunction within 7 days after randomization. 7 days day | — |
Countries
Thailand
Contacts
Public ContactSripassorn Thongchai
Mahidol university
Outcome results
None listed