Hemodynamic Optimisation Guided With Transcranial Doppler in Septic Shock

Hemodynamic Optimisation Guided With Transcranial Doppler in Septic Shock

Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase.

patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses:

• Group 1: standard hemodynamic goals and catecholamin infusion to achieve: mean arterial pressure > or equal to 65 mmHg and diastolic arterial pressure > ou equal to 50 mmHg within the first 60 minutes.
• Group 2: personalized hemodynamic goals and catecholamin infusion until normal transcranial doppler: IP<1,2.

Randomized, controlled, prospective trial, including ICU patients with Sepsis or septic Shock, at the early phase.

patients will be randomized in 2 groups regarding the hemodynamic management and catecholamin doses:

• Group 1: standard hemodynamic goals and cathecolamin infusion to achieve: mean arterial pressure > or equal to 65 mmHg and diastolic arterial pressure > ou equal to 50 mmHg within the first 60 minutes.
• Group 2: personalized hemodynamic goals and cathecolamin infusion until normal transcranial doppler: IP<1,2.

For the 2 groups, standard management including: microbiological sampling, early broad spectrum anti infective therapy, fluid management and decreasing of blood lactate levels, will be aimed within the first 60 minutes.

For the Group 2 patients: personalized hemodynamic management will be maintained during 72 hours.

Inclusion Criteria:

• All ICU patients presenting septic shock
• No criteria of traumatic or vascular brain injury

Exclusion Criteria:

• Patients with refractory septick shock
• rapid fatal evolution: before 72 hours
• No individualisation of the MCA ultrasonographic window