Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase. patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses: * Group 1: standard hemodynamic goals and catecholamin infusion to achieve: mean arterial pressure \> or equal to 65 mmHg and diastolic arterial pressure \> ou equal to 50 mmHg within the first 60 minutes. * Group 2: personalized hemodynamic goals and catecholamin infusion until normal transcranial doppler: IP\<1,2.
Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase. patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses: * Group 1: standard hemodynamic goals and cathecolamin infusion to achieve: mean arterial pressure \> or equal to 65 mmHg and diastolic arterial pressure \> ou equal to 50 mmHg within the first 60 minutes. * Group 2: personalized hemodynamic goals and cathecolamin infusion until normal transcranial doppler: IP\<1,2. For the 2 groups, standard management including: microbiological sampling, early broad spectrum anti infective therapy, fluid management and decreasing of blood lactate levels, will be aimed within the first 60 minutes. For the Group 2 patients: personalized hemodynamic management will be maintained during 72 hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
24
hemodynamic optimisation aiming to achieve normal cerebral perfusion: titration of catecholamin infusion.
Mongi Slim Hospital
Tunis, Tunisia
RECRUITINGmortality at day 28
Mortality at day 28
Time frame: 28 days after ICU admission
Incidence of sepsis associated encephalopathy
sepsis associated encephalopathy assessed by CAM-ICU and GCS scores
Time frame: 28 days after ICU admission
Incidence of sepsis related organ failures
sepsis related organ failures assessed with SOFA score
Time frame: 28 days after ICU admission
Length of ICU stay
Length of ICU stay
Time frame: 30 days after end of randomization
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