Impact of Midodrine Administration on the Clinical Outcome of Septic Shock Patients

Impact of Midodrine Administration on the Clinical Outcome of Septic Shock Patients

1. Assess the impact of midodrine administration on weaning of IV vasopressors
2. Assess the cost effectiveness of using midodrine in critically ill patients

A prospective randomized controlled clinical trial on total 60 critically ill patients admitted to critical care medicine department with indication to IV vasopressor due to septic shock on admission or during intensive care unit stay and they are randomly assigned to either of 2 groups as follows

1. Group 1(n=30):will receive IV vasopressor infusion only
2. Group 2(n=30):will receive midodrine in addition to IV vasopressor infusion

Inclusion Criteria:

1. Adult patients (18-80)years
2. Hypotensive (systolic blood pressure<90mm Hg)and require IV vasopressor for more than 24 hours
3. Require IV vasopressor at rate < 8mcg/min and unable to wean for >24 hours

Exclusion Criteria:

1. Severe organic heart disease (ejection fraction <30 percent due to higher risk of arrythmia)
2. Bradycardia (HR<50 b/m)due to higher likelihood of symptomatic bradycardia
3. Chronic kidney disease (serum creatinine >2mg/dl) as midodrine and its active metabolites are almost completely execreated in urine
4. Thyrotoxicosis
5. Known allergy to midodrine