Comparison And Outcomes Of Fluid Resucitation With 0.9% Normal Saline And 5% Albumin In Cirrhosis Patients With Sepsis Induced Hypotension

Study Overview
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Brief Summary
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300 consecutive patients with cirrhosis of any aetiology admitted with features of sepsis and sepsis induced hypotension to the intensive care unit, the emergency department and the step down units of Institute of Liver and Biliary Sciences, New Delhi, who fulfil the inclusion criteria. This study will be a single centre prospective randomized comparative trial. Patients will be randomized into two groups. Group A will receive crystalloid, 0.9% sodium chloride solution (total of 30ml/kg over 30 minutes) and Group B will receive colloid, 5% albumin (250 ml over 15 minutes).

Official Title
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Comparison And Outcomes Of Fluid Resucitation With 0.9% Normal Saline And 5% Albumin In Cirrhosis Patients With Sepsis Induced Hypotension

Conditions
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Cirrhosis With Septic Shock

Intervention / Treatment
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* Drug: 5% albumin Infusion
* Drug: 0.9% sodium chloride solution


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cirrhotic patients of any aetiology with Infection - suspected or documented and Mean arterial pressure less than 65 mm of Hg Exclusion Criteria: Cirrhosis patients in septic shock who are already on vasopressors and/or inotropes Cirrhosis patients in septic shock with structural heart disease Cirrhosis patients in septic shock with chronic renal failure/dialysis dependent/volume overloaded state Cirrhosis patients in shock, caused by other reasons, other than septic shock Cirrhosis patients in septic shock in whom contraindication to internal jugular or subclavian line insertion is present Age less than 18 years Previous episode of septic shock during the same hospital stay Pregnant or lactating women Patients in need for emergent surgical interventions Cirrhosis patients in septic shock with chronic obstructive lung disease and right heart failure Cirrhosis patients in septic shock with associated upper gastrointestinal bleed or coagulopathy related bleed with a haemoglobin of less than 8g/dL or requiring urgent transfusions of blood and blood products A previous adverse reaction to human albumin solution

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 5% albumin Infusion<br>(250 ml over 15 to 30 minutes) | Drug: 5% albumin Infusion<br>* colloid, 5% albumin (250 ml over 15 to 30 minutes).<br>|
| Active Comparator: 0.9% sodium chloride solution<br>0.9% sodium chloride solution (total of 30ml/kg over 15 to 30 minute) | Drug: 0.9% sodium chloride solution<br>* 0.9% sodium chloride solution (total of 30ml/kg over 15 to 30 minutes)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total number of patients with MAP (Mean Arterial Pressure) ≥ 65 |  | 3 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in lactate dynamics |  | 3 hours | 
| Total number of patients with Urine output >/= 0.5mL/kg/hr. |  | 3 hours | 
| Mortality |  | 7 days |