Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients (NCT04693923) | Clinical Trial Compass
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Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients
Chile42 participantsStarted 2021-02-01
Plain-language summary
In septic shock patients, the hemodynamic coherence between systemic, regional and microcirculatory blood flow can be tracked by "capillary refill time (CRT) response to an increase in stroke volume induced by a rapid fluid challenge". A parallel improvement in regional blood flow, microcirculation and hypoperfusion-related parameters should be expected in CRT-responders as reflection of preserved hemodynamic coherence. CRT non-response is associated with a more severe systemic inflammatory state, endothelial and microvascular dysfunction, and a higher adrenergic tone.
The objective of this study is to determine if CRT response after a rapid fluid challenge signals a state of hemodynamic coherence as demonstrated by a parallel improvement in regional and microcirculatory blood flow in CRT-responders, and to explore the pathophysiological mechanisms associated to CRT non-response.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Septic shock according to the Sepsis-3 Consensus Conference \[1\], basically septic patients with hypotension requiring norepinephrine (NE) to maintain a MAP of 65 mmHg, and serum lactate levels \> 2 mmol/l after initial fluid resuscitation.
✓. Less than 24h after fulfilling criteria for septic shock
✓. Abnormal CRT (\>3 secs)
✓. Mechanical ventilation
✓. Sinus rhythm with positive predictors of fluid responsiveness \[4\]
✓. Continuous CO monitor, arterial line and central venous catheters in place
✓. Required fluid challenge as decided by the attending physician.
Exclusion criteria
✕. Pregnancy
✕. Emergency surgery or dialytic procedure scheduled within the next two hours
✕. Do-not-resuscitate status
What they're measuring
1
Normalization of capillary refill time (CRT)
Timeframe: At baseline, and immediately after the single fluid challenge; then at 30 minutes, and 1, 2, 6 and 24h.