Sepsis is one of the most serious healthcare problems, worldwide, and financial burdens. The overall mortality of severe sepsis/septic shock was 44.5-52.6%. A common cause of death is refractory shock and multi-organ failure. Myocardial dysfunction is a relatively common complication of septic shock. This causes a decrease in the amount of cardiac output, resulting in insufficient blood supply to the organ and multi-organ failure and lead to death Early goal-directed therapy began to use dobutamine in patients with septic shock Sepsis Survival Campaign Guideline 2016 recommended drug is dobutamine and an alternative drug is milrinone in septic shock patients with clinical signs of poor tissue perfusion.
According to several studies, the use of dobutamine increases the amount of cardiac output but it has also been reported to increase mortality rates too. There are few studies of milrinone in patients with septic shock.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
64
Prepare milrinone 20 mg with NSS 100 ml then starts dose 0.5 mg/kg/min for up to 12 hours.
Hat Yai Hospital
Hat Yai, Changwat Songkhla, Thailand
RECRUITINGDepartment of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University
Bangkok, Thailand
RECRUITINGThe change of cardiac output from baseline (before study drug administration) to 6 hours (during study administration)
by echocardiogram or Pulse contour analysis or Thermodilution technique from pulmonary artery catheter
Time frame: upto 24 hours
Intensive care unit (ICU) mortality
Proportion of participant who die during ICU admission
Time frame: upto 120 days
Hospital mortality
Proportion of participant who die during hospital admission
Time frame: upto 120 days
28-day mortality
Proportion of participant who die during 28 days after enrollment
Time frame: upto 28 days
Dose of vasopressor after intervention
present as vasopressor equivalent dose compare before and after intervention, and percent of decrease
Time frame: upto 7 days
Lactate clearance
lactate level after and before intervention and percent clearance
Time frame: upto 7 days
Mechanical ventilator free day
day of the patient does not use mechanical ventilator during admission
Time frame: upto 28 days
Extracorporeal membrane oxygenation (ECMO) or Renal replacement therapy (RRT)
incident of initial ECMO or RRT
Time frame: upto 28 days
Incident of tachyarrhythmia
Incident of ventricular tachycardia, ventricular fibrillation, Atrial fibrillation
Time frame: upto 28 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.