Effects of Increasing Mean Arterial Pressure on Renal Function in Patients With Shock and With Elevated Central Venous Pressure

Launched by UNIVERSITY HOSPITAL, ANGERS · Dec 14, 2022

Keywords

ClinConnect Summary

Current recommandation for mean arterial pressure (MAP) target is 65 mmHg for septic shock, but optimal target to prevent acute renal failure (ARF) remains unknown.

High central venous pressure (CVP) can lead to acute renal failure through venous congestion , and is associated with acute renal failure in intensive care unit.

A decrease of renal perfusion pressure, defined by MAP - CVP, has been shown to be associated with risk of acute renal failure.

The main objective of this trial is to evaluate if an optimisation of renal perfusion pressure, by a higher MAP when CVP is high (≥ 12 cmH2...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients (≥ 18 years old )
• • Arterial hypotension requiring the etablishment of catecholamines
• • Norepinephrine dose ⩾ 0.1µg/kg/min at the inclusion
• • High central venous pressure ≥ 12mmHg
• • Cardiac output monitoring (PICCO or Swan Ganz)
• Exclusion Criteria:
• • Anuria
• • Patient with an emergency indication of renal replacement therapy (severe hyperkalemia, severe metabolical acidosis with pH \<7.15, acute pulmonary edema due to fluid overload resulting in severe hypoxemia, serum urea concentration \> 40 mmol/l)
• • Pregnant, lactating or parturient woman
• • Patient deprived of liberty by judicial or administrative decision
• • Patient with psychiatric compulsory care
• • Patient subject to legal protection measures
• • Patients with do-no-reanimate order or withdrawal of life sustaining support

Trial Officials