Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The aim of our study is to compare between transcranial doppler pulsatility index and mean arterial blood pressure in guiding management of sepsis induced encephalopathy.
Sepsis induced encephalopathy is the most frequent sepsis related organ dysfunction. It appears early during the course of infection, often before any other organ involvement in up to 70% of hospitalized septic patients and is associated with significant change of cerebral circulation caused by redistribution of blood flow during sepsis that accompanies the abnormal inflammatory response during an infection, in absence of direct central nervous system involvement.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transcranial doppler pulsatility index guided protocol | Experimental | Norepinephrine titration that will be guided by Transcranial doppler (TCD) pulsatility index. |
|
| Mean arterial blood pressure guided protocol | Active Comparator | Norepinephrine titration that will be guided by Mean arterial blood pressure (MAP). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcranial doppler pulsatility index guided protocol | Other | Norepinephrine titration that will be guided by Transcranial doppler pulsatility index. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Intensive care unit (ICU) mortality | Incidence of Intensive care unit (ICU) stay will be recorded | 28 day or till death which earlier |
| Measure | Description | Time Frame |
|---|---|---|
| Mean arterial pressure | Fluid resuscitation will be started using crystalloids at a rate of 4 to 6 ml/kg with reevaluation after 15 minutes. If MAP is still less than 65 mmhg, fluid resuscitation should be continued at a rate of 4 to 6 ml/kg with reevaluation after another 15 minutes up to 30 ml/kg. Vasopressors will be started if the patient is still hypotensive during or after resuscitation without delay even peripherally to avoid delay until central venous access is secured (norepinephrine is the first line agent preferred over other vasopressors). |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Mai S Aboshaara, MD | Assistant lecturer | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University Hospitals | Tanta | Elgharbia | 31527 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39755598 | Derived | Salem MS, Abosabaa MA, Abd El Ghafar MS, Ei-Gendy HMEM, Alsherif SEI. Norepinephrine titration in patients with sepsis-induced encephalopathy: cerebral pulsatility index compared to mean arterial pressure guided protocol: randomized controlled trial. BMC Anesthesiol. 2025 Jan 4;25(1):5. doi: 10.1186/s12871-024-02814-0. |
Not provided
Not provided
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Mean arterial blood pressure guided protocol | Other | Norepinephrine titration that will be guided by Mean arterial blood pressure (MAP). |
|
| 24 hours |
| Norepinephrine titration | Fluid resuscitation will be started using crystalloids at a rate of 4 to 6 ml/kg with reevaluation after 15 minutes. If MAP is still less than 65 mmhg, fluid resuscitation should be continued at a rate of 4 to 6 ml/kg with reevaluation after another 15 minutes up to 30 ml/kg. Vasopressors will be started if the patient is still hypotensive during or after resuscitation without delay even peripherally to avoid delay until central venous access is secured (norepinephrine is the first line agent preferred over other vasopressors). | 24 hours |
| Cerebral perfusion pressure | Cerebral perfusion pressure (CPP) will be done using transcranial doppler. | 24 hours |
| Outcome of encephalopathy | Encephalopathy outcome at ICU discharge using Glasgow coma scale (GCS) | 28 day |
| SOFA score | SOFA score at ICU admission and discharge. | Up to 4 weeks. |
| Length of ICU stay | Length of ICU stay | At least 28 days |
| ID | Term |
|---|---|
| D018805 | Sepsis |
| D001927 | Brain Diseases |
| ID | Term |
|---|---|
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
Not provided
Not provided