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Transpulmonary Thermodilution and Transesophageal Echocardiography in Early Septic Shock (HEMOSEPSIS)

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ClinicalTrials.gov Identifier: NCT01188993
Recruitment Status : Completed
First Posted : August 26, 2010
Last Update Posted : August 22, 2018
Sponsor:
Information provided by (Responsible Party):
University Hospital, Limoges

Brief Summary:
The purpose of this study is to assess the concordance of therapeutic changes proposed after an early hemodynamic evaluation (hemodynamic profile) in septic shock patients using jointly the transpulmonary thermodilution technique and transesophageal echocardiography (TEE).

Condition or disease Intervention/treatment Phase
Septic Shock Combination Product: early septic shock Phase 4

Detailed Description:
Each patient will be assessed by both the transpulmonary thermodilution technique and TEE (H0). The two assessments will be performed in random order (central randomization stratified by participating center), but within 30 minutes (no change of ongoing treatment during the assessment period). Two investigators not involved in patient care and blinded to the results of the alternative technique will performed independently the hemodynamic assessment using one of the two modalities for hemodynamic assessment tested in the study. They will interpret the results at bedside and propose a therapeutic change to the attending physician, according to the hemodynamic profile. The latter will finally: precisely identify the clinical problem to be solved (e.g., therapeutic target of the Surviving Sepsis Campaign not reached, tissue hypoperfusion), choose a therapy adapted while taking into account the clinical scenario and the results of both the transpulmonary thermodilution and TEE, evaluate the efficacy of this treatment (problem solved or not) and its tolerance (potential side-effect attributable to the treatment). In addition, the presence or resolution of signs of tissue hypoperfusion will systematically be assessed at H6, H12 and H24. Primary and secondary outcomes will be assessed by an independent committee of experts.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 153 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Hemodynamic Assessment With Transpulmonary Thermodilution and Transesophageal Echocardiography in Patients With Early Septic Shock
Study Start Date : January 2011
Actual Primary Completion Date : January 2014
Actual Study Completion Date : December 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Shock

Arm Intervention/treatment
Active Comparator: septic shock TPT then TEE
Group 1: Each patient will be assessed by both the transpulmonary thermodilution technique and transesophageal echocardiography (TEE)..
Combination Product: early septic shock
Each patient will be assessed by both the transpulmonary thermodilution and Transesophageal Echocardiography.

Active Comparator: septic shock TEE then TPT
Goup 2: Each patient will be assessed by both transesophageal echocardiography (TEE) and the transpulmonary thermodilution technique.
Combination Product: early septic shock
Each patient will be assessed by both the transpulmonary thermodilution and Transesophageal Echocardiography.




Primary Outcome Measures :
  1. therapeutic procedure following the hemodynamic assessment [ Time Frame: 2 years ]
    Changes in therapy proposed after the hemodynamic assessment (hemodynamic profile) by each of the two tested methods: blood volume expansion (preload responsiveness), positive inotrope (cardiac dysfunction), vasopressor (vasoplegia), no change in ongoing therapy or dose tapering (inotropes or vasopressor).


Secondary Outcome Measures :
  1. efficacy and safety of therapeutic intervention [ Time Frame: 2 years ]
    Efficacy (clinical problem solved) and tolerance (potential side-effects) of the therapeutic change.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • ventilated patient in sinus rhythm with septic shock requiring a hemodynamic assessment

Exclusion Criteria:

  • < 18 yr-old
  • pregnancy
  • contra-indication for TEE, non sinus rhythm, aplasia, prior participation to the study, hemodynamic assessment using any other technique than those tested in the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01188993


Locations
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France
Bordeaux UH
Bordeaux, France, 33 076
Toulouse UH
Toulouse, France, 31 059
Sponsors and Collaborators
University Hospital, Limoges

Publications of Results:
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Responsible Party: University Hospital, Limoges
ClinicalTrials.gov Identifier: NCT01188993    
Other Study ID Numbers: I09003
First Posted: August 26, 2010    Key Record Dates
Last Update Posted: August 22, 2018
Last Verified: August 2010
Additional relevant MeSH terms:
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Shock, Septic
Shock
Pathologic Processes
Sepsis
Infection
Systemic Inflammatory Response Syndrome
Inflammation