Sepsis Clinical Trial
Official title:
Evaluation of Fluid Infusion With LifeFlow for Patients With Suspected Septic Shock
The LifeFlow rapid infusion device is a handheld manually-operated device that has been shown in early trials to increase the rate of bolus fluid infusion up to 3 times the rate of delivery attributed to conventional rapid infusion devices. The device addresses other technical barriers to fluid resuscitation, including reducing complexity and provider fatigue. LifeFlow utilizes standard IV or intraosseous (IO) vascular access devices to quickly and efficiently deliver appropriate volumes of crystalloid fluid to patients during emergent fluid resuscitation. The purpose of this study is to determine if intravenous fluids can be administered more rapidly and efficiently with the use of the LifeFlow rapid infusion device compared to the current standard techniques in adult patients who present to the Emergency Department with septic shock.
Patients with conditions such as septic shock, anaphylaxis, and hypovolemic shock may require
rapid fluid administration to restore blood pressure and tissue perfusion. Newly Updated
Surviving Sepsis Campaign (SSC) guidelines call for patients with septic shock to receive a
30ml/kg intravenous (IV) fluid challenge within 1 hour of emergency department (ED) arrival,
with improved outcomes shown with early fluid infusion. Patients with shock and severe
hypotension may require even more rapid fluid treatment, up to 4ml/kg/min. While excess fluid
infusion may be associated with harm, early fluid infusion for the reversal of shock can
reduce the need for subsequent interventions, ultimately leading to improved patient
outcomes. This may be especially true in patients with hypotension, who are at greater risk
of death if not treated quickly, as a single episode of hypotension in patients with sepsis
is correlated with a significantly increased risk of death.
In patients who require IV fluid bolus therapy, technical barriers such as slow infusion
rates, technically complex infusion devices, and inadequate nursing resources may lead to
delay in fluid administration and inadequate resuscitation. As recommended by the SSC
guidelines, patients receiving fluid bolus therapy for septic shock require frequent
reassessment of clinical response. With current fluid delivery techniques, the ability to
reassess quickly and relate fluid administration directly to markers of hemodynamic
improvement is limited.
The LifeFlow rapid infusion device is a handheld manually-operated device that has been shown
in early trials to increase the rate of bolus fluid infusion up to 3 times the rate of
delivery attributed to conventional rapid infusion devices. The device addresses other
technical barriers to fluid resuscitation, including reducing complexity and provider
fatigue. LifeFlow utilizes standard IV or intraosseous (IO) vascular access devices to
quickly and efficiently deliver appropriate volumes of crystalloid fluid to patients during
emergent fluid resuscitation.
The purpose of this study is to determine if intravenous fluids can be administered more
rapidly and efficiently with the use of the LifeFlow rapid infusion device compared to the
current standard techniques in adult patients who present to the Emergency Department with
septic shock.
Primary Hypothesis
- Intravenous fluids can be administered more rapidly and efficiently with the use of the
LifeFlow rapid infusion device compared to the current techniques in patients who
present to the ED with hypotension and suspected septic shock Secondary Hypotheses
- Hypotensive patients receiving intravenous fluids utilizing the LifeFlow infusion device
will have more rapid normalization of vital sign parameters (i.e., resolution of
hypotension = MAP 65 mmHg or greater), and more rapid improvement in markers of tissue
ischemia (i.e., lactate clearance) than patients receiving fluid using other techniques.
- Based on reduced ICU and hospital length of stay (LOS), the overall cost of treatment
will be lower in ED patients receiving early IV fluid resuscitation with LifeFlow
comparted to similar patients treated with standard techniques.
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