The Randomized Controlled Trial of Inferior Vena Cava Ultrasound-guided Fluid Management in Septic Shock Resuscitation

Launched by CHULALONGKORN UNIVERSITY · Jan 11, 2017

Keywords

ClinConnect Summary

Septic shock (SS) is globally prevalent in with high mortality rate.The current focuses on initial treatment of this condition emphasize on the early recognition, prompt administration of antibiotic, and restoration of hemodynamic with aggressive fluid resuscitation and vasopressor. Regarding the initial fluid therapy, administration of empirical crystalloid at the dose of 30 ml/kg is recommended in the guideline. The ultrasound-assisted management of shock patients has been introduced in the past decade and now is widely used. By using the measurement of inferior vena cava (IVC) diameter c...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient who attended the emergency department with septic shock (defined by those who require a vasopressor to maintain a mean arterial pressure (MAP) of 65 mm Hg or greater and whose serum lactate level greater than 2 mmol/L in the absence of hypovolemia.)
• Exclusion Criteria:
• • 1) Congestive pulmonary edema or known to have poor systolic cardiac function (left ventricular ejection fraction ≤ 40%).
• • 2) Known to have right heart pathologies.
• • 3) Having or suspected to have marked ascites, significant bowel dilatation or the conditions that can cause abdominal hypertension.
• • 4) Body mass index ≥ 30 kg/square meter.
• • 5) Having concomitant attack of severe airway disease (eg. Asthma, COPD) that may have confounded the IVC interpretation due to the positive intrathoracic pressure.
• • 6) IVC can not be identified or its diameter cannot be measured correctly.
• • 7) Having end-stage renal diseases with or without dialysis.
• • 8) Having non-infectious diseases as final diagnoses.
• • 9) Pregnant women.
• • 10) Have been referred or treated from other healthcare facility.
• • 11) Having active hemorrhages.
• • 12) Duplicated cases.
• • 13) who had "do-not-resuscitate" living will.
• • 14) Declined to consent.