scholarly journals Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial

2002 ◽  
Vol 28 (10) ◽  
pp. 1434-1439 ◽  
Author(s):  
Rolf Busund ◽  
Vladimir Koukline ◽  
Uri Utrobin ◽  
Edvard Nedashkovsky
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Randomised Controlled ◽  
Sepsis And Septic Shock

scholarly journals Targeting skeletal muscle tissue oxygenation (StO2) in adults with severe sepsis and septic shock: a randomised controlled trial (OTO-StS Study)

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017581 ◽  
Author(s):  
Olivier Nardi ◽  
Elizabeth Zavala ◽  
Claude Martin ◽  
Serafim Nanas ◽  
Thomas Scheeren ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Septic Shock ◽  
Mechanical Ventilation ◽  
Severe Sepsis ◽  
Randomised Controlled Trial ◽  
Near Infrared ◽  
Controlled Trial ◽  
Control Group ◽  
Randomised Controlled ◽  
Sepsis And Septic Shock

ObjectiveEvaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2in adults with severe sepsis or septic shock.DesignA European randomised controlled trial was performed on two parallel groups.SettingFive intensive care units (ICU) in France, Greece, Spain and Germany were used for the study.ParticipantsA total of 103 adults with severe sepsis or septic shock on ICU admission were randomised (54 subjects in the experimental arm and 49 subjects in the control arm).InterventionsHaemodynamic management using an algorithm that was adapted from the 2004 Surviving Sepsis Campaign guidelines with (experimental arm) or without (control arm) targeting an StO2value greater than 80% at a minimum of two different sites.OutcomesThe primary outcome was a composite: 7-day all-cause mortality or worsening of organ function, defined as a positive difference in Sepsis-related Organ Failure Assessment (SOFA) score between day 7 and randomisation (ie, delta SOFA >0). Secondary endpoints: 30-day mortality, duration of mechanical ventilation and vasopressor therapy up to 30 days from randomisation.ResultsThe study ended prematurely due to lack of funding after enrolment of 103/190 patients. Eighteen patients (33.3%) in the experimental arm and 14 (28.6%, P=0.67) in the control arm died or exhibited delta SOFA >0 on day 7. The mean number of days on mechanical ventilation was 12.2±10.6 in the experimental group and 7.6±7.9 in the control group (P=0.03). Thirty-one (57%) patients in the experimental arm and 14 (29%) patients in the control arm received red cells by day 7 (P=0.01).ConclusionDespite the limitation related to premature termination, this study provides no data to support the routine implementation of resuscitation protocols incorporating StO2>80% at two or more muscle sites as a target. StO2-guided therapy may be associated with prolonged use of mechanical ventilation and an increased number of red blood cell transfusions.Trial registration numberNCT00167596; Results.

scholarly journals Fluids in Sepsis and Septic Shock (FISSH): protocol for a pilot randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (7) ◽  
pp. e017602 ◽  
Author(s):  
Bram Rochwerg ◽  
Tina Millen ◽  
Peggy Austin ◽  
Michelle Zeller ◽  
Frédérick D’Aragon ◽  
...  
Keyword(s):  
Septic Shock ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Pilot Randomised Controlled Trial ◽  
Randomised Controlled ◽  
Sepsis And Septic Shock

scholarly journals Protocol for a randomised controlled trial of VAsopressin versus Noradrenaline as Initial therapy in Septic sHock (VANISH)

BMJ Open ◽  
2014 ◽  
Vol 4 (7) ◽  
pp. e005866-e005866 ◽  
Author(s):  
A. C. Gordon ◽  
A. J. Mason ◽  
G. D. Perkins ◽  
D. Ashby ◽  
S. J. Brett
Keyword(s):  
Septic Shock ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Initial Therapy ◽  
Randomised Controlled

scholarly journals Echocardiography-Guided Hemodynamic Management of Severe Sepsis and Septic Shock in Adults: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Walid S. Alhabashy ◽  
Osama M. Shalaby ◽  
Ahmed S. Elgebaly ◽  
Mohammed S. Abd El Ghafar
Keyword(s):  
Septic Shock ◽  
Randomized Controlled Trial ◽  
Severe Sepsis ◽  
Controlled Trial ◽  
Total Fluid Intake ◽  
Early Goal Directed Therapy ◽  
Randomized Controlled ◽  
Group I ◽  
Hospital Stays ◽  
Sepsis And Septic Shock

Abstract Background: Echocardiography (ECHO) is used to guide septic shock resuscitation, but without evidence for efficacy. Therefore, we compared the outcome of early goal-directed therapy (EGDT) and ECHO-guided management of hemodynamics in severe sepsis and septic shock. Materials and Methods: This is a single center, randomized controlled trial conducted on 100 adult patients with severe sepsis or septic shock. Patients were assessed and treated with either EGDT protocol (EGDT group) or ECHO-guided resuscitation protocol (ECHO group). Results: Only 87 patients (45 in group I and 42 in group II) were analyzed. There was a significant increase of mean norepinephrine and dobutamine doses and a significant decrease in total fluids in the first 24 hours, time to normalization, time to weaning of vasopressors, total MV days, MV free days and ICU and hospital stays in ECHO group. At 30 days, the mortality rate in EGDT group was 35.6% which was significantly higher compared to 14.3% in ECHO group. At 90 days, the overall mortality was significantly higher in EGDT group compared to Echo group (40.0% vs 16.7% respectively). Hazardous ratio of mortality was 1.630 (95% confidence interval (CI): 1.123 - 2.366) and 1.653 (95% CI: 1.137 - 2.404) at 30 and 90 days respectively in EGDT group compared to ECHO group. Conclusions: In severe sepsis and septic shock, ECHO-guided management of hemodynamics resulted in a decrease in mortality, lower total fluid intake, higher vasopressor and inotrope support, earlier weaning of vasopressors and less MV days, ICU and hospital stay.

Sign in / Sign up

Export Citation Format

Share Document