This phase 2 study aim to investigate the effect of dobutamine in patients with sepsis/ septic shock after fluid resuscitation and with hypoperfusion (lactate and central venous oxygen saturation or prolonged capillary refill time) on renal function as compared with usual care.
In this phase 2 study patients with sepsis/ septic shock and signs of persistent hypoperfusion after fluid resuscitation will be randomized to receive either dobutamine or no intervention in addition to usual care. Dobutamine will be used for 48 hours. Hypoperfusion will be assessed by altered lactate levels and a low SvO2 or prolonged capillary refill time. Both arms will receive usual care according to the Surviving Sepsis Campaign guidelines. Dobutamine dosis will be adjusted to achieve improvement in the perfusion parameters according to a pre specified protocol. Pre specified criteria will be used to stop the drug for safety. The primary outcome will be creatinine at Day 3. Other secondary and safety outcomes will also be assessed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Intravenous infusion of dobutamine in incremental dosis according to perfusion markers for a period of 48 hours after randomization.
Federal University of São Paulo
São Paulo, Brazil
Serum creatine on the third day
Serum creatinine corrected by fluid balance on the third day
Time frame: 3 days
ICU mortality
death in the ICU truncated at 60 days
Time frame: 60 days
Renal replacement therapy up to day 7
need for renal replacement therapy within the first 7 days after randomization
Time frame: 7 days
Hospital mortality
death in the hospital truncated at 60 days
Time frame: 60 days
Vasopressors free days up to day 7
Days without vasopressors support within the first 7days after randomization
Time frame: 7 days
ICU free days up to day 28th
Days out of the ICU within the first 28 days after randomization
Time frame: 28 days
Severe arrhythmia
Occurence of severe arrhythmia defined by the need for cardioversion (electric or chemical)
Time frame: 7 days
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