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The study was halted early due to low patient accrual secondary to COVID-19 and significant heterogeneity in clinical manifestations of sepsis precluding enrollment.
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There is a knowledge gap regarding the optimal initial fluid to achieve effective resuscitation and improved outcomes in septic shock. The purpose of this study is to compare initial resuscitation with plasma to initial resuscitation with balanced crystalloids.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| initial resuscitation with plasma | Experimental | Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. |
|
| initial resuscitation with balanced crystalloids | Active Comparator | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Plasma | Drug | Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. |
| Measure | Description | Time Frame |
|---|---|---|
| Glycocalyx Breakdown as Assessed by Syndecan-1 Levels | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and at 24 hours | |
| Glycocalyx Breakdown and Endothelial Leakage as Assessed by Soluble Thrombomodulin (sTM) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours | |
| Endothelial Leakage as Assessed by Soluble FMS-like Tyrosine Kinase-1 (sFLT-1) | 0, 2, end of initial bolus of fluid administration(about 3 hours), 12, and 24 hours | |
| Endothelial Leakage and Inflammation as Assessed by Vascular Endothelial Growth Factor (VEGF) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours | |
| Sympatho-adrenal Activation as Assessed by Norepinephrine (NE) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours | |
| Sympatho-adrenal Activation as Assessed by Epinephrine (Epi) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours | |
| Inflammation as Assessed by Soluble Receptor for Advanced Glycation Endproduct (sRAGE) | 0, 2, end of initial bolus of fluid administration, 12, and 24 hours | |
| Inflammation as Assessed by High Mobility Group Protein-1 (HMGB-1) | 0, 2, end of initial bolus of fluid administration, 12, and 24 hours | |
| Measure | Description | Time Frame |
|---|---|---|
| Total Volume of Fluid Required for Resuscitation After the Initial Bolus of Either Plasma or Crystalloids | Data were not collected for 1 participant in the initial resuscitation with plasma arm. | First 24 hours after initiation of fluid resuscitation |
| Time Until Lactate Normalization |
Not provided
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Shuyan Wei, MD | The University of Texas Health Science Center, Houston | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Texas Health Science Center at Houston | Houston | Texas | 77030 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30271882 | Derived | Wei S, Kao LS, Wang HE, Chang R, Podbielski J, Holcomb JB, Wade CE. Protocol for a pilot randomized controlled trial comparing plasma with balanced crystalloid resuscitation in surgical and trauma patients with septic shock. Trauma Surg Acute Care Open. 2018 Sep 23;3(1):e000220. doi: 10.1136/tsaco-2018-000220. eCollection 2018. |
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Patients with a sepsis screening score > or equal to 4 (which indicates potential sepsis) and with a suspected source of infection were enrolled, and they were later randomized if septic shock developed, per the protocol. Only 8 enrolled patients progressed to septic shock, and therefore only 8 participants were randomized and started the protocol.
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| ID | Title | Description |
|---|---|---|
| FG000 | Initial Resuscitation With Plasma | Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. Plasma: Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. |
| FG001 | Initial Resuscitation With Balanced Crystalloids | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. Balanced crystalloids: Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
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| ID | Title | Description |
|---|---|---|
| BG000 | Initial Resuscitation With Plasma | Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. Plasma: Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Glycocalyx Breakdown as Assessed by Syndecan-1 Levels | Data was not collected at end of initial bolus of fluid administration (about 3 hours) and 24 hours for one participant in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | ng/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and at 24 hours |
|
30 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Initial Resuscitation With Plasma | Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. Plasma: Initial resuscitation with plasma will be 10 mL/kg (700 mL in a typical 70 kg adult). Traditional doses of plasma, when used to correct coagulopathy range from 10-15 mL/kg.23 The plasma will be administered at a rate of 2-3 mL/kg/hr (140-210 mL/hr in a typical 70 kg adult). A research physician will be at bedside to follow patient resuscitation. Plasma administration may be terminated before the entire dose is administered if patients show clinical improvement. After the initial dose of plasma has been given, subsequent resuscitation will follow usual care using balanced crystalloids. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute Kidney Injury | Renal and urinary disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Lillian S Kao | The University of Texas Health Science Center at Houston | (713) 500-6280 | Lillian.S.Kao@uth.tmc.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 26, 2019 | Feb 7, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D012772 | Shock, Septic |
| ID | Term |
|---|---|
| D018805 | Sepsis |
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
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|
| Balanced crystalloids | Drug | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. |
|
| Inflammation as Assessed by Interleukin-6 (IL-6) |
| 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
| Inflammation as Assessed by Interleukin-8 (IL-8) | 0, 2, end of initial bolus of fluid administration (about 3 hours) , 12, and 24 hours |
| Inflammation as Assessed by Interleukin-10 (IL-10) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
| Inflammation as Assessed by Interleukin-1α (IL-1α) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
| Inflammation as Assessed by Interleukin-1β (IL-1β) | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
| First 24 hours after initiation of fluid resuscitation |
| Time on Vasopressors | First 30 days after initiation of fluid resuscitation |
| Number of Days on Ventilator Support | First 30 days after initiation of fluid resuscitation |
| Number of Intensive Care Unit (ICU)-Free Days | First 30 days after initiation of fluid resuscitation |
| Number of Hospital Days | From the time of initiation of fluid resuscitation to the time of hospital discharge (up to about 170 days) |
| Mortality | First 30 days after initiation of fluid resuscitation |
| Number of Participants With Acute Lung Injury | First 30 days after initiation of fluid resuscitation |
| Number of Participants With Acute Kidney Injury | First 30 days after initiation of fluid resuscitation |
| BG001 | Initial Resuscitation With Balanced Crystalloids | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. Balanced crystalloids: Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | Initial Resuscitation With Balanced Crystalloids | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. Balanced crystalloids: Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. |
|
|
| Primary | Glycocalyx Breakdown and Endothelial Leakage as Assessed by Soluble Thrombomodulin (sTM) | Data was not collected at end of initial bolus of fluid administration (about 3 hours) and at 24 hours for one participant in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | ng/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Endothelial Leakage as Assessed by Soluble FMS-like Tyrosine Kinase-1 (sFLT-1) | Data was not collected for this outcome measure. | Posted | 0, 2, end of initial bolus of fluid administration(about 3 hours), 12, and 24 hours |
|
|
| Primary | Endothelial Leakage and Inflammation as Assessed by Vascular Endothelial Growth Factor (VEGF) | In the plasma arm, sample levels were out of range and thus no value could be obtained for 3 participants at all time points. In the balanced crystalloids arm, sample levels were out of range and thus no value could be obtained for 3 participants at 0, 2, and 12 hours; for 2 at about 3 hours and at 24 hours; and for all 4 at 12 hours--in addition to those with sample levels out of range, there was 1 other participant for whom no data at all were collected at 3 hours and 24 hours. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Sympatho-adrenal Activation as Assessed by Norepinephrine (NE) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Sympatho-adrenal Activation as Assessed by Epinephrine (Epi) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. Sample levels were out of range and thus no value could be obtained for one participant at 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Inflammation as Assessed by Soluble Receptor for Advanced Glycation Endproduct (sRAGE) | Data was not collected for this outcome measure. | Posted | 0, 2, end of initial bolus of fluid administration, 12, and 24 hours |
|
|
| Primary | Inflammation as Assessed by High Mobility Group Protein-1 (HMGB-1) | Data was not collected for this outcome measure. | Posted | 0, 2, end of initial bolus of fluid administration, 12, and 24 hours |
|
|
| Primary | Inflammation as Assessed by Interleukin-6 (IL-6) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Inflammation as Assessed by Interleukin-8 (IL-8) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours) , 12, and 24 hours |
|
|
|
| Primary | Inflammation as Assessed by Interleukin-10 (IL-10) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. Sample levels were out of range and thus no value could be obtained for one participant at 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours in the initial resuscitation with plasma arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Inflammation as Assessed by Interleukin-1α (IL-1α) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Primary | Inflammation as Assessed by Interleukin-1β (IL-1β) | Data was not collected for one participant at the end of initial bolus of fluid administration (about 3 hours) and 24 hours in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | pg/mL | 0, 2, end of initial bolus of fluid administration (about 3 hours), 12, and 24 hours |
|
|
|
| Secondary | Total Volume of Fluid Required for Resuscitation After the Initial Bolus of Either Plasma or Crystalloids | Data were not collected for 1 participant in the initial resuscitation with plasma arm. | Posted | Mean | Standard Deviation | mL | First 24 hours after initiation of fluid resuscitation |
|
|
|
| Secondary | Time Until Lactate Normalization | Posted | Mean | Standard Deviation | hours | First 24 hours after initiation of fluid resuscitation |
|
|
|
| Secondary | Time on Vasopressors | Data were not collected for 2 participants in the initial resuscitation with plasma arm and 2 participants in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | hours | First 30 days after initiation of fluid resuscitation |
|
|
|
| Secondary | Number of Days on Ventilator Support | Data were not collected for 1 participant in the initial resuscitation with balanced crystalloids arm. | Posted | Mean | Standard Deviation | days | First 30 days after initiation of fluid resuscitation |
|
|
|
| Secondary | Number of Intensive Care Unit (ICU)-Free Days | Posted | Mean | Standard Deviation | days | First 30 days after initiation of fluid resuscitation |
|
|
|
| Secondary | Number of Hospital Days | Posted | Mean | Standard Deviation | days | From the time of initiation of fluid resuscitation to the time of hospital discharge (up to about 170 days) |
|
|
|
| Secondary | Mortality | Posted | Count of Participants | Participants | First 30 days after initiation of fluid resuscitation |
|
|
|
| Secondary | Number of Participants With Acute Lung Injury | Data was not collected for this outcome measure. | Posted | First 30 days after initiation of fluid resuscitation |
|
|
| Secondary | Number of Participants With Acute Kidney Injury | Data was not collected for this outcome measure. | Posted | First 30 days after initiation of fluid resuscitation |
|
|
| 1 |
| 4 |
| 4 |
| 4 |
| 0 |
| 4 |
| EG001 | Initial Resuscitation With Balanced Crystalloids | Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. Balanced crystalloids: Usual care using balanced crystalloids (Iso-Lyte or Plasma-Lyte) only will follow Surviving Sepsis Campaign guidelines. Controls will receive 30 mL/kg (2100 mL in a typical 70 kg adult) of crystalloids within the first 3 hours. Subsequent resuscitation with balanced crystalloids will be titrated to the endpoints of resuscitation. | 1 | 4 | 4 | 4 | 0 | 4 |
| Liver failure | Hepatobiliary disorders | Systematic Assessment |
|
| Clostridium difficile colitis | Gastrointestinal disorders | Systematic Assessment |
|
| atrial fibrillation requiring multiple cardioversions | Cardiac disorders | Systematic Assessment |
|
| acute renal failure requiring intermittent hemodialysis | Renal and urinary disorders | Systematic Assessment |
|
| Enterocutaneous fistula | Gastrointestinal disorders | Systematic Assessment |
|
| acute renal failure requiring continuous renal replacement therapy/intermittent hemodialysis | Renal and urinary disorders | Systematic Assessment | (resolved) |
|
| acalculous cholecystitis | Hepatobiliary disorders | Systematic Assessment |
|
| medication induced blindness | Eye disorders | Systematic Assessment |
|
| Deep vein thrombosis with persistent anemia requiring inferior vena cava filter | Vascular disorders | Systematic Assessment |
|
| anemia requiring Inferior vena cava filter | Blood and lymphatic system disorders | Systematic Assessment |
|
| chylothorax | Blood and lymphatic system disorders | Systematic Assessment |
|
| multiple episodes of severe sepsis secondary to urinary tract infection | Infections and infestations | Systematic Assessment |
|
| bacteremia | Infections and infestations | Systematic Assessment |
|
| Gastrointestinal bleed | Gastrointestinal disorders | Systematic Assessment |
|
| Pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Urinary tract infection | Renal and urinary disorders | Systematic Assessment |
|
| Ascending colon perforation | Gastrointestinal disorders | Systematic Assessment |
|
| Congestive heart failure exacerbation/flash pulmonary edema | Cardiac disorders | Systematic Assessment |
|
| Worsening acute kidney injury requiring continuous renal replacement therapy to be restarted | Renal and urinary disorders | Systematic Assessment |
|
| Respiratory Failure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Traumatic brain injury (tracheostomy & percutaneous endoscopic gastrostomy) | Nervous system disorders | Systematic Assessment |
|
Not provided
Not provided
Not provided
| D010335 |
| Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012769 | Shock |
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|
| 2 hours |
|
|
| end of initial bolus of fluid administration (about 3 hours) |
|
|
| 12 hours |
|
|
| 24 hours |
|
|