Shock Clinical Trial
Official title:
Prospective, Randomized, Multi-center Trial Aiming to Determined the Impact of Changeovers of Norepinephrine on the Blood Pressure Stability With Patients in Shock in ICU.
CHIC study's purpose is to compare the efficiency, in terms of blood pressure stability, of
three changeovers of norepinephrine used routinely in ICU. The three techniques are:
- Quick change
- Double pumping
- Smart infusion pumps
The drugs used in intensive care units are numerous and their administration is based on a
strong expertise in this context of urgency and complexity. Nurses role is not only to carry
out preparation of a treatment but to implement a complex treatment that requires a risk
management approach surpassing the simple task to which the decree of professional acts
refers to.
In this context, the administration of catecholamines, widely used in intensive care medicine
in the treatment of shock, appears to be a sensitive issue to study. These vasoactive drugs
have a short half-life and a narrow therapeutic index. Administration should be careful
ensuring both efficiency and prevention of complications such as hemodynamic instability or
arrhythmias.
Administration of these therapeutic must be strictly continuous, that is to say delivered
using electric syringe pumps. Syringe replacements appear as critical moments because of the
risk of flow change or brief interruption of the infusion.
There are three main types of syringes relay techniques, but to date, no study has compared
these techniques with each other. There is thus no recommendation based on objective datas to
guide clinical nursing practice.
This study aims to provide evidence in order to secure the administration of catecholamines.
It may also use as a reference for evaluation of new features that allow automation relays
with called "smart pumps" and for which no study has demonstrated the added value in terms of
security. No progress will be possible in securing the administration of drugs with a short
half-life, narrow therapeutic index and significant side effects without a deep reflection of
the conditions of their infusion. The choice of materials used and the development of care
procedures must be based on reliable and timely recommendations. Patients expect safer care.
Nurses must be able to have references enabling them to guide their practice to the benefit
of patients.
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