Comparison of Microcirculation Indexes and Hemodynamic Indexes to Guide Resuscitation in Patients With Septic Shock

Study Overview
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Brief Summary
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Comparison of Microcirculation Indexes and Hemodynamic Indexes to Guide Resuscitation in Patients With Septic Shock

Detailed Description
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Objectives: Comparison of microcirculation indexes and hemodynamic indexes to guide resuscitation in patients with septic shock. Intervention: Microcirculation-oriented resuscitation group: When the system hemodynamics meets the standard of EDGT, the microcirculation-oriented resuscitation group will evaluate the organ perfusion level and adjust the hemodynamic therapy according to the sublingual microcirculation parameters (PPV > 68%). Control group: The standard treatment group will adjust the shock management scheme through systemic hemodynamic parameters. Primary outcome: (1)change in SOFA score at 72h (2)30-day mortality

Official Title
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Comparison of Microcirculation Indexes and Hemodynamic Indexes to Guide Early Fluid Resuscitation in Patients With Septic Shock

Conditions
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Sepsis

Intervention / Treatment
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* Device: sublingual microcirculation,
* Device: hemodynamic monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients fulfilled the diagnostic criteria of septic shock. Exclusion Criteria: declined to participate pregnant patients who were younger than 18 years old active bleeding septic shock is diagnosed for more than 4 hours patients are expected to be die within 24hours

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Microcirculation-oriented resuscitation group<br>The microcirculation-oriented resuscitation group will evaluate the organ perfusion level and adjust the hemodynamic therapy according to the sublingual microcirculation parameters (PPV > 68%). | Device: sublingual microcirculation,<br>* Avoiding pressure artifacts, clear stable microvascular images were taken for a minimum of 20 seconds of the left, middle, and right sections of the tongue.<br>Device: hemodynamic monitoring<br>* Arterial blood lactic acid (Lac), central venous oxygen saturation (ScvO2), hematocrit (HCT) and entral venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2) will be measured employing a bedside blood gas machine on admission and six hours following admission.<br>|
| Other: Control group<br>The standard treatment group will adjust the shock management scheme through systemic hemodynamic parameters. | Device: hemodynamic monitoring<br>* Arterial blood lactic acid (Lac), central venous oxygen saturation (ScvO2), hematocrit (HCT) and entral venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2) will be measured employing a bedside blood gas machine on admission and six hours following admission.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in SOFA score | △SOFA | 72h | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30-day mortality | mortality | 30d | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Septic shock; Sublingual Microcirculation