Targeting Abdominal Perfusion Pressure in Septic Shock — MAP-APP  

Acute Kidney Injury Clinical Trial

Official title: Targeting Abdominal Perfusion Pressure in Septic Shock (The MAP APP Study)

Status Terminated

Clinical Trial Summary

A randomized control trial among patients with septic shock, studying the incidence, progression and recovery of AKI.

Clinical Trial Description

Intra-abdominal pressure (IAP) has proven to be an important physiologic parameter in critically ill patients, and elevated IAP can lead to intra-abdominal hypertension (IAH). Literature suggests that IAH is common in patients with septic shock and that there is an association between the presence of IAH and acute kidney injury (AKI) in this group. Mean arterial pressure (MAP) and IAP together help determine the abdominal perfusion pressure (APP) of organs and tissues within the abdominal cavity. Current clinical guidelines for septic shock encourage targeting MAP of 65-70 mmHg with the use of vasopressors after volume resuscitation. However, it remains unclear if hemodynamic support targeting APP: (a) reduces development of acute kidney injury (AKI), (b) decreases progression of AKI, or (c) improves renal recovery rate compared to standard care for severe septic shock patients. A novel Foley catheter and monitoring device, the Accuryn Monitoring System, is capable of detecting physiologic changes in temperature, urine output (UO) and intra-abdominal pressure (IAP). These data streams are captured continuously by a device that is minimally invasive and at a high frequency which, in combination with MAP, allow for a simple calculation of abdominal perfusion pressure (APP). The purpose of this study is to assess kidney function and recovery in septic shock patients and elevated IAP when targeting treatment to maintain APP ≥ 60 mmHg as compared to standard of care targeting MAP of 65-70 mmHg. ;

Related Conditions & MeSH terms

• Acute Kidney Injury
• Resuscitations
• Septic Shock
• Shock
• Shock, Septic

• NCT number: NCT03582046
• Study type: Interventional
• Source: Potrero Medical
• Status: Terminated
• Phase: N/A
• Start date: February 5, 2019
• Completion date: June 20, 2020