Septic shock Shock, Septic Ultrasonography Fluid Therapy
Conditions
Interventions
Participants in the intervention group will receive fluid management guided by bedside lung ultrasound and femoral vein Doppler. These ultrasound assessments are used to detect signs of congestion and
Ultrasound-guided fluid management,standard care
Sponsors
Ramathibodi hospital
Eligibility
Sex/Gender
All
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: 1.Adults aged 18 years or older 2.Septic shock with mean arterial pressure less than 65 mmHg and signs of poor tissue perfusion (such as delayed capillary refill, altered consciousness, or oliguria) 3.Endotracheal intubation 4.Admission to ICU within 48 hours
Exclusion criteria
Exclusion criteria: 1.Clinical evidence of volume overload, including pulmonary edema or tissue edema 2.Pregnancy 3.Patients who refuse fluid resuscitation, vasopressor therapy, or endotracheal intubation 4.Requirement for immediate surgery 5.Participation in another clinical study 6.Contraindications to lung ultrasound, such as open chest wound, rib fractures, extensive subcutaneous emphysema, or severe skin infection at probe site
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in SOFA score from baseline to 72 hours 72 hours after randomization Point difference in SOFA score | — |
Secondary
| Measure | Time frame |
|---|---|
| 28-day Mortality 28 days Percentage of participants who died,28-day Vasopressor-Free Days 28 days Number of days alive and free from vasopressor support within 28 days,Total Fluid Administered 72 hr 72 hr Total intravenous fluid volume administered in 72 hr,Time to Vasopressor Initiation From randomization to initiation of vasopressor therapy Time (in hours) from study randomization until the first administration of any,Development of Pulmonary Edema During ICU stay Presence/absence (Yes/No),Length of ICU Stay From randomization to ICU discharge Days,Incidence of Acute Kidney Injury (AKI) During ICU stay Number and percentage of participants with AKI | — |
Countries
Thailand
Contacts
Public ContactPachara Saengngammongkhol
Ramathibodi Hospital
Outcome results
None listed