Octreotide is used to decrease portal pressure of cirrhotic patients admitted for variceal bleeding. When patients are in haemorrhagic shock, the recommended drug to increase arterial pressure is norepinephrine. Microcirculatory effects of octreotide when it is added to noradrenaline has not been investigated yet. The aim of the study is to evaluate the effect of octreotide plus norepinephrine for patient with haemorrhagic shock after variceal bleeding.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Patients admitted in intensive care unit after variceal hemorrhage treated with norepinephrine perfusion will received an additional octreotide perfusion during one hour.
CHU Amiens Picardie
Amiens, France
Change from baseline of microcirculatory flow index
microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas.
Time frame: one hour after octreotide perfusion
Change from baseline of microcirculatory flow index
microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas.
Time frame: 2 hours after octreotide perfusion
Change from baseline of microcirculatory flow index
microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas.
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Time frame: 6 hours after octreotide perfusion
Change from baseline of microcirculatory flow index
microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas.
Time frame: 12 hours after octreotide perfusion
Change from baseline of microcirculatory flow index
microcirculatory flow index will be measured with sidestream dark field handheld microscope. Baseline is before octreotide perfusion. Flow characteristics of the microvasculature will be quantified using the microcirculatory flow index (MFI) according to the recommendations from the consensus on microcirculatory imaging by De Backer et al. This index will be calculated after the image will be divided into four quadrants, and the predominant type of flow (absent = 0, intermittent = 1, sluggish = 2, abnormal = 3, and hyperdynamic = 4) would be estimated in the vessels smaller than 25 μm by the operator. The final MFI score is a value obtained from the average score of the four areas.
Time frame: 24 hours after octreotide perfusion
percentage of perfused vessels
percentage of perfused vessels will be measured with sidestream dark field handheld microscope
Time frame: before and one hour after octreotide perfusion
percentage of perfused vessels
percentage of perfused vessels will be measured with sidestream dark field handheld microscope
Time frame: 2 hours after octreotide perfusion
percentage of perfused vessels
percentage of perfused vessels will be measured with sidestream dark field handheld microscope
Time frame: 6 hours after octreotide perfusion
percentage of perfused vessels
percentage of perfused vessels will be measured with sidestream dark field handheld microscope
Time frame: 12 hours after octreotide perfusion
percentage of perfused vessels
percentage of perfused vessels will be measured with sidestream dark field handheld microscope
Time frame: 24 hours after octreotide perfusion
functional capillary density
functional capillary density will be measured with sidestream dark field handheld microscope
Time frame: before and one hour after octreotide perfusion
functional capillary density
functional capillary density will be measured with sidestream dark field handheld microscope
Time frame: 2 hours after octreotide perfusion
functional capillary density
functional capillary density will be measured with sidestream dark field handheld microscope
Time frame: 6 hours after octreotide perfusion
functional capillary density
functional capillary density will be measured with sidestream dark field handheld microscope
Time frame: 12 hours after octreotide perfusion
functional capillary density
functional capillary density will be measured with sidestream dark field handheld microscope
Time frame: 24 hours after octreotide perfusion
Mean arterial pressure
Mean arterial pressure
Time frame: before and one hour after octreotide perfusion
Mean arterial pressure
Mean arterial pressure
Time frame: 2 hours after octreotide perfusion
Mean arterial pressure
Mean arterial pressure
Time frame: 6 hours after octreotide perfusion
Mean arterial pressure
Mean arterial pressure
Time frame: 12 hours after octreotide perfusion
Mean arterial pressure
Mean arterial pressure
Time frame: 24 hours after octreotide perfusion
heart rate
heart rate
Time frame: before and one hour after octreotide perfusion
heart rate
heart rate
Time frame: 2 hours after octreotide perfusion
heart rate
heart rate
Time frame: 6 hours after octreotide perfusion
heart rate
heart rate
Time frame: 12 hours after octreotide perfusion
heart rate
heart rate
Time frame: 24 hours after octreotide perfusion
ejection fraction
ejection fraction
Time frame: before and one hour after octreotide perfusion
ejection fraction
ejection fraction
Time frame: 2 hours after octreotide perfusion
ejection fraction
ejection fraction
Time frame: 6 hours after octreotide perfusion
ejection fraction
ejection fraction
Time frame: 12 hours after octreotide perfusion
ejection fraction
ejection fraction
Time frame: 24 hours after octreotide perfusion