High MAP in Septic Shock With Hypertension

Southeast University, China19 enrolled

Overview

We hypothesized that the increase in MAP from 65 mmHg to patients' usual level improved sublingual microcirculation.

The effect of mean arterial pressure (MAP) titration to higher level on microcirculation in septic shock patients with previous hypertension remains unknown. Our goal was to assess the effect of MAP titration to patients' usual level on microcirculation in septic shock patients with previous hypertension. We hypothesized that the increase in MAP from 65 mmHg to patients' usual level improved sublingual microcirculation.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Septic Shock

Interventions

NEOTHER

norepinephine

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with septic shock for less than 24 hours * Fluid resuscitation was performed according to the guideline for treating septic shock to maintain the central venous pressure (CVP) for more than 8 mm Hg and central venous oxygen saturation for more than 70% * Patients requiring norepinephrine (NE) to maintain a MAP of 65 mm Hg. Septic shock patients with fluid resuscitation after CVP \> 8mmHg and mean blood pressure \> 65 mmHg Exclusion Criteria: * Pregnancy * Age \< 18 years * Inability to acquire the usual level of MAP * Refusal of consent by the patient or relative * Participation in other trials during the last three months * Hypertensive patients without hypertension treatment

Locations (1)

Zhongda Hospital Southeast University

Nanjing, Jiangsu, China

Outcomes

Primary Outcomes

Mean Arterial Pressure

As chronic hypertensive patients were supposed to have undergone more blood pressure measurements in daily life than non-hypertensive ones, the averaged MAP acquired from patients' physical examination records of the last two years was registered and assumed as patients' usual level of MAP and target MAP. If patients' medical records were incomplete, a detailed enquiry about the target MAP to their next kin was performed. After stabilization for 30 min, basal measurements including hemodynamic and microcirculatory measurements were taken, 20 min apart, the NE doses were increased to titrate MAP to the target level. Patients were allowed to stabilize for 30 min before taking new measurements.

Time frame: Target MAP stabilization for 30 min

Secondary Outcomes

Perfused Vessel Density

Increasing MAP from 65 mm Hg to target level. The sublingual microcirculation was measured by sidestream dark field, including the parameters of perfused vessel density

Time frame: Target MAP stabilization for 30 min

Data from ClinicalTrials.gov

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