Critical Care Ultrasound Oriented Shock Treatment in ICU

Study Overview
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Brief Summary
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Objective To investigate whether critical care ultrasound oriented shock management in shock patients in intensive care unit(ICU) can improve outcome. Methods Randomized controlled research. Patients were randomly allocated to two groups. In the critical care ultrasound oriented shock management group (CUSS group), treatment was oriented by the findings of critical care ultrasound in each shock phase, while in the control group the decisions about the monitoring and management were made by the clinical team. The goal of treatments in both groups were decreasing lactate by 20% or more per 2 hours for the Optimization phase in shock management, and no increase lactate level when removing the fluid in de-escalation phase. The primary outcome measure were hospital mortality and 28-day mortality, the secondary outcome measure were the length of ventilation and the length of ICU stay.

Official Title
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Critical Care Ultrasound Oriented Shock Treatment in ICU

Conditions
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Shock

Intervention / Treatment
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* Other: Critical care ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: SBP <90 mm Hg or MAP <65 mm Hg or SBP decrease >40mmHg or need vasoactive drugs； Skin that is cold and clammy，capillary refill time >4.5s，urine output of<0.5ml/Kg.hr and lactate >2mmol/L； SHOCK presented within 6 hr. Exclusion Criteria: <18 years old； Pregnancy； Patient or family member refuse to be enrolled.

Ages Eligible for Study
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Minimum Age: 18 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: control group<br>usual care | |
| Experimental: critical care ultrasound<br>Circulation management will be adjusted according to the results of critical ultrasound combined with clearance of lactic acid in patients with shock. | Other: Critical care ultrasound<br>* Circulateory will be managed according to the result of critical ultrasound joint clearance of lactic acid in patients with shock<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 28-day mortality | 28-day mortality | through study completion,an average of 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the length of ICU stay | the length of ICU stay | through study completion,an average of 28 days | 
| the total length of hospital stay | the total length of hospital stay | through study completion,an average of 28 days | 
| the incidence of AKI | the incidence of AKI | through study completion,an average of 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lactate, Shock, Critical Care Ultrasound, Mortality, Prognosis