REmote Ischemic COnditioning in Septic Shock

REmote Ischemic COnditioning in Septic Shock: The RECO-Sepsis Study

Septic shock remains a major public health problem in industrialized countries, with a mortality rate as high as 50%, largely related to multiple organ dysfunction. In addition to dysregulated inflammatory response, the pathophysiology of organ failures in septic shock involves ischemia-reperfusion processes. Remote ischemic conditioning is a therapeutic strategy for protecting organs against the detrimental effects of ischemia-reperfusion injury.

The objective of the present study is to determine whether remote ischemic conditioning can limit the severity of organ failure in patients with septic shock.

Inclusion Criteria:

• Age ≥ 18 years
• Hospitalization in an intensive care unit for less than 24 hours
• Septic shock evolving for less than 12 hours defined as:
• Documented or suspected infection
• Norepinephrine administration to maintain a mean arterial pressure ≥ 65 mmHg after volemia correction
• Lactatemia > 2 mmol/L at least once in the past 12 hours before inclusion
• Written informed consent signed by the patient or by a next of kin or oral consent given by the patient and as soon as permitted by the clinical state written informed consent signed by the patient.

Exclusion Criteria:

• Patient who has expressed the wish not to be resuscitated
• Contraindication of the use of brachial cuff on both arms
• Intercurrent pathology with an expected life expectancy of less than 24 hours
• Cardiac arrest
• Female patients currently pregnant or women of childbearing age who are not using contraception
• Previous inclusion in RECO-Sepsis study
• Previous inclusion in another clinical study
• Patients without health coverage