Critical Care Ultrasound Oriented Shock Treatment in ICU

Sichuan University

Status: Completed

Conditions: Shock

Treatments: Other: Critical care ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT03093987

West China Hos

Details and patient eligibility

About

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.

Enrollment: 150 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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150 participants in 2 patient groups

control group

No Intervention group

Description:

usual care

critical care ultrasound

Experimental group

Description:

Circulation management will be adjusted according to the results of critical ultrasound combined with clearance of lactic acid in patients with shock.

Treatment:

Other: Critical care ultrasound