The Construction and Application of Therapeutic System of Intelligent Decision-Oriented Hemodynamic Organized Therapy for Shock Patients

Peking Union Medical College Hospital60 enrolled

Overview

Patients with septic shock with norepinephrine \>0.25ug/kg/min were enrolled. Informed consent was obtained for inclusion in the study and random assignment into the combination or norepinephrine group. Contact the research assistant to obtain patient number information and print out the appropriate labels.Notify the ward dispensing nurse to open the experimental drug cassette (placed in the refrigerator 4℃ drug cabinet). Extract the corresponding experimental medication according to the patient label number, dispense it and send it to the ward, label it and hand it over to the bedside nurse to start using it. The time point at which the medication was connected to the patient and activated was recorded as the zero point for the start of the study. The data were monitored according to the time points specified in the study: baseline,0h , 6h, D1, D2, and post-drug withdrawal.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Septic Shock

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Septic shock patients with norepinephrine\>0.25ug/kg/min Exclusion Criteria: 1. Under 18 years of age 2. Acute coronary syndrome requiring treatment 3. have been treated with VA-ECMO 4. VV-ECMO treatment has been administered for less than 12 hours 5. Patient is on posterior pituitary hormone 6. Patients with liver failure with a Model for End-Stage Liver Disease (MELD) score ≥ 30 7. Patients requiring more than 500 mg of hydrocortisone or equivalent glucocorticoid daily as a fixed dose 8. absolute neutrophil counts below 1,000/mm3 9. Patients with active bleeding who are expected to require (within 48 hours of study entry) transfusion of more than 4 units of red blood cell concentrate patients with active bleeding that is expected to require (within 48 hours of study entry) transfusion of more than 4 units of red blood cell concentrate 10. malignancy or other irreversible disease or condition with an estimated 6-month mortality rate of ≥50% 11. Confirmed or suspected acute mesenteric ischemia. If the investigator believes that the patient's condition is highly suspicious but not confirmed by conventional criteria The investigator may exclude a patient if, in the opinion of the investigator, the patient's condition is highly suspicious but not confirmed by conventional criteria, or if the treating physician has initiated empiric therapy. 12. Likely death expected within 12 hours 13. Family or physician plans to implement a palliative care plan for the patient

Outcomes

Primary Outcomes

28days-Mortality in ICU

28 day mortality rate

Time frame: 28 days

ICU duration

Residence time in ICU

Time frame: an average of 1 year