The objectives of this study are to evaluate the effect of continuous intravenous Landiolol injection (from 0.5 to 10 µg/kg/min during 12 hours ) up to a 15% decrease in Heart Rate (HR) on microcirculatory vascular reactivity vs. usual tachycardia management and evaluate the hemodynamic effects of Landiolol vs. usual management in patients with septic shock.
This is a Phase 3, prospective, randomized, open label, evaluation of the efficacy of continuous intravenous Landiolol injection up to a 15% decrease in HR on microcirculatory vascular reactivity vs. usual tachycardia management. Design: A monocentric, open-label, randomised, superiority clinical trial Sample size : 44 patients, 22 in each group Treatments groups: Continuous intravenous Landiolol injection ( from 0.5 to 10 µg/kg/min during 12 hours ) up to a 15% decrease in HR on microcirculatory vascular reactivity vs usual tachycardia management Treatment duration : 24 hours Assessement: Landiolol (Rapibloc)'s perfusion will be started at T0 at 0.5 mcg/kg/min and increased by 0.5 mcg/kg/min every 30 minutes in order to achieve a 15% (T1) decrease in HR, within the limit of 10 mcg/kg/min. Then the dosage will be maintained for 2 hours (T2) then the drug will be stopped gradually over 2 hours. Maximum duration of Landiolol infusion will be 12 hours. No interim analysis is planned. Analysis will be performed at the end of the study after data review and freezing of database.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
44
Intravenous Landiolol injection (from 0.5 to 10 µg/kg/min during 12 hours) up to a 15% decrease in HR on microcirculatory vascular reactivity.
Intensive care department, Hôpital Saint Antoine
Paris, France
RECRUITINGRate of decrease in heart rate (HR) on microcirculatory vascular reactivity
The objectives of this study are to evaluate the effect of continuous intravenous Landiolol injection (from 0.5 to 10 µg/kg/min during 12 hours ) up to a 15% decrease in HR on microcirculatory vascular reactivity vs. usual tachycardia management in patients with septic shock.
Time frame: 24 hours
Cardiac flow
Measure of the cardiac flow to evaluate the hemodynamic effects of Landiolol vs. usual tachycardia management
Time frame: 24 hours
marbling score
Measure of the marbling score to evaluate the effects of Landiolol vs. usual tachycardia management
Time frame: 24 hours
skin recoloration time
Measure of skin recoloration time to evaluate the effects of Landiolol vs. usual tachycardia management
Time frame: 24 hours
Arterial lactate clearance
Measure of sarterial lactate clearance to evaluate the effects of Landiolol vs. usual tachycardia management
Time frame: 24 hours
Measure of Systemic and endothelial inflammation parameters
Evaluate the hemodynamic effects of Landiolol vs. usual tachycardia management on Systemic and endothelial inflammation parameters: Plasma cytokines (Procartaplex) VCAM-1 (vascular endothelial cell adhesion molecule), Soluble Endocan (ELISA)
Time frame: 24 hours
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