Critical Care Ultrasound Oriented Shock Treatment in ICU
NCT ID: NCT03093987
Last Updated: 2017-11-01
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
150 participants
INTERVENTIONAL
2017-04-05
2017-10-28
Brief Summary
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To investigate whether critical care ultrasound oriented shock management in shock patients in intensive care unit(ICU) can improve outcome.
Methods
Randomized controlled research. Patients were randomly allocated to two groups. In the critical care ultrasound oriented shock management group (CUSS group), treatment was oriented by the findings of critical care ultrasound in each shock phase, while in the control group the decisions about the monitoring and management were made by the clinical team. The goal of treatments in both groups were decreasing lactate by 20% or more per 2 hours for the Optimization phase in shock management, and no increase lactate level when removing the fluid in de-escalation phase. The primary outcome measure were hospital mortality and 28-day mortality, the secondary outcome measure were the length of ventilation and the length of ICU stay.
Detailed Description
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Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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control group
usual care
No interventions assigned to this group
critical care ultrasound
Circulation management will be adjusted according to the results of critical ultrasound combined with clearance of lactic acid in patients with shock.
Critical care ultrasound
Circulateory will be managed according to the result of critical ultrasound joint clearance of lactic acid in patients with shock
Interventions
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Critical care ultrasound
Circulateory will be managed according to the result of critical ultrasound joint clearance of lactic acid in patients with shock
Eligibility Criteria
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Inclusion Criteria
* Skin that is cold and clammy，capillary refill time \>4.5s，urine output of\<0.5ml/Kg.hr and lactate \>2mmol/L；
* SHOCK presented within 6 hr.
Exclusion Criteria
* Pregnancy；
* Patient or family member refuse to be enrolled.
18 Years
ALL
No
Sponsors
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West China Hospital
OTHER
Responsible Party
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tongjuan ZOU
Professor
Locations
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West China Hospital of Sichuan University
Chengdu, Sichuan, China
Countries
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References
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Lichtenstein D. Fluid administration limited by lung sonography: the place of lung ultrasound in assessment of acute circulatory failure (the FALLS-protocol). Expert Rev Respir Med. 2012 Apr;6(2):155-62. doi: 10.1586/ers.12.13.
Schmidt GA, Koenig S, Mayo PH. Shock: ultrasound to guide diagnosis and therapy. Chest. 2012 Oct;142(4):1042-1048. doi: 10.1378/chest.12-1297.
Holm JH, Frederiksen CA, Juhl-Olsen P, Sloth E. Perioperative use of focus assessed transthoracic echocardiography (FATE). Anesth Analg. 2012 Nov;115(5):1029-32. doi: 10.1213/ANE.0b013e31826dd867. Epub 2012 Oct 9. No abstract available.
Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008 Jul;134(1):117-25. doi: 10.1378/chest.07-2800. Epub 2008 Apr 10.
Manno E, Navarra M, Faccio L, Motevallian M, Bertolaccini L, Mfochive A, Pesce M, Evangelista A. Deep impact of ultrasound in the intensive care unit: the "ICU-sound" protocol. Anesthesiology. 2012 Oct;117(4):801-9. doi: 10.1097/ALN.0b013e318264c621.
Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013 Oct 31;369(18):1726-34. doi: 10.1056/NEJMra1208943. No abstract available.
Bhat SR, Swenson KE, Francis MW, Wira CR. Lactate Clearance Predicts Survival Among Patients in the Emergency Department with Severe Sepsis. West J Emerg Med. 2015 Dec;16(7):1118-26. doi: 10.5811/westjem.2015.10.27577. Epub 2015 Dec 8.
Other Identifiers
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West China Hos
Identifier Type: -
Identifier Source: org_study_id