Non-cardiac Surgery Clinical Trial
Official title:
Vasopressin or Norepinephrine in Vasoplegic Shock After Non-cardiac Surgery: a Randomized and Controlled Trial
The purpose of the present study is to evaluate the effect of vasopressin compared to norepinephrine on the clinical complications of patients with vasospastic shock after noncardiac surgeries.
The Systemic Inflammatory Response Syndrome (SIRS) is a common complication after non-cardiac surgery, impacting negatively on patient outcome and with high incidence rates. Vasoplegic syndrome is the most serious complication of SIRS and can happen after any type of surgery. The etiology of the vasoplegic syndrome has not yet been fully elucidated, but is known to occur more frequently in patients at high surgical risk, submitted to major surgeries, or in the presence of perioperative complications and patients with comorbidities. In this circumstance, the depletion of vasopressin stocks is described, which may contribute to the refractoriness of the shock and the lack of response to the catecholaminergic drugs. The standard treatment of perioperative vasoplegia has been adequate volume replacement and administration of vasopressors, with norepinephrine being the most commonly used. However, it is known that norepinephrine may have deleterious effects on the body and in 20% of patients with vasospastic shock it is ineffective. Previous studies have suggested benefits of adding vasopressin in refractory situations, especially in septic shock. Recently the VANCS study (Vasopressin or norepinephrine in the vasopregic shock after cardiac surgery: double-blind, controlled and randomized study) demonstrated superiority of vasopressin in the reversion of vasoplegic shock after cardiac surgery, as well as a lower incidence of renal insufficiency, atrial fibrillation and shorter hospitalization time. (Anesthesiology. 2017 Jan;126(1):85-93.) ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03715712 -
NORepinephrine-Maintaining-individuaALIZEd Blood Pressure
|
N/A | |
Recruiting |
NCT05733208 -
The Effect of Remote Ischemic Preconditioning on Myocardial Injury After Noncardiac Surgery
|
N/A | |
Completed |
NCT04058769 -
Software-guided Guideline Implementation in Premedication
|
N/A | |
Completed |
NCT03213496 -
Promotion of Ambulation Before Non-cardiac Surgery
|
N/A | |
Recruiting |
NCT01758952 -
Incidence and Risk Factors of Peri-operative Stroke in Non-cardiac,Non-neurosurgical Surgeries
|
||
Not yet recruiting |
NCT04705064 -
Artificial Intelligence and Postoperative Acute Kidney Injury
|
||
Active, not recruiting |
NCT04453722 -
Prevention of Opioid-Induced Hypoxemia
|
||
Recruiting |
NCT05242419 -
A Study of Huperzine A Injection in Reducing Postoperative Delirium in Elderly Patients Undergoing Non-cardiac Surgery
|
N/A | |
Completed |
NCT04843202 -
Clinical Guidelines in Premedication Visit
|
||
Recruiting |
NCT05481723 -
Lung Ultrasound-guided Hemodynamic Optimization
|
N/A | |
Active, not recruiting |
NCT05188001 -
Hemodynamics and Myocardial Injury After Non-cardiac Surgery
|
||
Not yet recruiting |
NCT03028389 -
Effects of Limb Remote Ischemic Preconditioning for Prevention of Delirium in Elderly Patients After Non-cardiac Surgery
|
N/A | |
Recruiting |
NCT04996966 -
Effect of Human Umbilical Cord-derived Mesenchymal Stem Cells on Non-cardiac Surgery-induced Lung Injury
|
Phase 1 | |
Completed |
NCT02743884 -
Evaluating Heat Transfer With the Esophageal Cooling Device
|
N/A | |
Completed |
NCT01203605 -
European Surgical Outcomes Study
|
N/A |