Microcirculatory Guided Goal Directed Fluid Therapy in Septic Shock; a Feasibility Study

King's College London30 enrolled

Overview

Prospective single centre study to assess the feasibility of fluid resuscitation guided by macrocirculatory and microcirculation parameters in patients in the early stages of septic shock. The investigators will utilise a novel point of care tool to assess microcirculatory sublingual perfusion in patients with septic shock. This, in combination with conventional haemodynamic monitoring will determine the timing and volume of resuscitative fluid administration. The feasibility of this technique will be determined prior to embarking on a pilot RCT.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Septic Shock

Interventions

Intra venous fluidDRUG

Volume of intra venous fluid administered during GDT protocol

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Age \> 18 years Within 6 hours of ICU admission Evidence of suspected or confirmed infection Serial Organ Failure Assessment (SOFA) score increase of 2 or more (assuming baseline 0 if no previous measures) Requiring vasopressor therapy to maintain a MAP \> 65mmHg Lactate \> 2 mmol/l despite initial fluid resuscitation Requirement for advanced haemodynamic monitoring (PiCCO system) in the opinion of the attending clinician Exclusion Criteria: Patients not expected to survive 24 h in whom the intent of treatment is palliative Patients in whom the primary cause of the shock state is cardiogenic \-

Locations (1)

King's College Hospital NHS Foundation Trust

London, United Kingdom

RECRUITING

Outcomes

Primary Outcomes

Time to acquire POEM score

Feasibility measure of point of care test

Time frame: 6 hours

Effect of POEM score on clinical decision making

Feasibility outcome measure

Time frame: 6 hours

Central Contacts

Sam Hutchings, PhD

CONTACT

07832678654 sam.hutchings@nhs.net

Data from ClinicalTrials.gov

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