Septic Shock Clinical Trial
Official title:
Effects of Systemic Blood Pressure Targets on Cerebral Hemodynamics in Septic Shock: a Prospective Study
The sudy objective is to evaluate the cerebral haemodynamic status in different ranges of systemic arterial pressure in patients with septic shock by noninvasive tools, transcranial doppler and intracranial compliance by mechanical sensor (B4C). Patients participating in the study will be submitted to different levels of arterial pressure, titrated with vasopressor and them their cerebral hemodynamic variables will be evaluated,
Status | Recruiting |
Enrollment | 40 |
Est. completion date | July 7, 2024 |
Est. primary completion date | December 30, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - < 48 hours in the intensive care unit - Septic shock (sepsis 3.0) Exclusion Criteria: - No window for DTC - Hepatic or uremic encephalopathy - Pregnancy - Acute or prior structural neurological insult - Exogenous intoxication - Dementia - Chronic Obstructive Pulmonary Disease - Instability for acute arrhythmia - Extracorporeal support by modifying the pulse wave form (intra aortic balloon pump and Extracorporeal membrane oxygenation - Extreme severity, with imminent risk of death |
Country | Name | City | State |
---|---|---|---|
Brazil | São Rafael Hospital | Salvador | Bahia |
Lead Sponsor | Collaborator |
---|---|
D'Or Institute for Research and Education |
Brazil,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The primary objective is to evaluate the effects of cerebral haemodynamic in patients with septic shock in different targets of MAP, through ARI (by Transcranial Doppler), and intracranial compliance by mechanical sensor (B4C) | This outcome will be analyzed by transcranial Doppler (ARI, PI) and B4C (intracranial compliance) index). Data will be obtained at the time of collection (mean arterial pressure targets) and subsequently analyzed | Data will be obtained at the time of collection (mean arterial pressure targets) and subsequently analyzed | |
Secondary | Assess factors that influence cerebral autoregulation (by ARI) and intracranial compliance (B4C) | To verify clinical factors that influence cerebral autoregulation (CA) and intracranial compliance of septic patients | Data will be obtained at the time of collection (mean arterial pressure targets) and subsequently analyzed | |
Secondary | Evaluate the correlation between CA by TDC and B4C index. | Report the similarity between the two indices | Data will be obtained at the time of collection (mean arterial pressure targets) and subsequently analyzed | |
Secondary | Correlate mechanical ventilation time with perfusion pressure value | Observation that there is a correlation between the duration of mechanical ventilation and the patient's baseline perfusion pressure | Mechanical ventilation time up to 28 days | |
Secondary | Explore the correlation between incidence of brain dysfunction | Brain dysfunction will be considered as: Glasgow Coma Scale score < 15 or when disorientation, altered thinking or agitation was reported by the attending physician, independently of the use of sedatives/analgesics and in the absence of previous neurological diseases (i.e., dementia, cerebrovascular disease, brain tumors, previous traumatic brain injury) with DTC and B4C index. | Until 28º day |
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