Norepinephrine Dose Reduction and Critical Closing Pressure in Distributive Shock

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

In this observational study, clinicians reduce norepinephrine dose for eligible adults with distributive shock who are on MAP 75–85 mmHg and have a PiCCO catheter. Hemodynamic parameters, including critical closing pressure (Pcc), tissue perfusion pressure (TPP), mean systemic filling pressure analogue (Pmsf), and vascular waterfall (VW), are measured at baseline and about 30 minutes after dose reduction during controlled inspiratory holds. The approach relies on stepwise inspiratory hold maneuvers to derive Pcc from CO-MAP regression, ensuring stability by keeping MAP variation under 5 mmHg. No investigator-initiated intervention is performed beyond observing real-world dose reductions by the treating team.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Adult distributive shock patients aged ≥18 years;
2. Receiving norepinephrine infusion with MAP in the 75-85 mmHg range;
3. PiCCO catheter in situ;
4. Under mechanical ventilation;
5. Clinically indicated norepinephrine dose reduction per attending physician judgment.

Exclusion Criteria:

1. Significant cardiac arrhythmia affecting CO measurement reliability;
2. Contraindication to airway plateau pressure maneuver;
3. Active titration of other vasoactive agents within 30 minutes prior to measurement;
4. Hemodynamic instability making it impossible to reduce norepinephrine dose.

Where it's running

• Peking Union Medical College Hospital
  Beijing, Beijing Municipality, China Recruiting

Study contacts

• Study coordinator: Bin Du, Dr
• Email: sunyaliii@163.com
• Phone: 86+15136289398

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.