Oxygen use and carbon dioxide production after stabilizing blood flow in 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

This is a prospective observational study in adult ICU patients with signs of shock who receive standard hemodynamic optimization such as fluid boluses or vasopressors. VO2 and VCO2 will be measured continuously using a dedicated ventilator-based gas monitor and compared with values calculated from veno-arterial dissolved gas measurements. Patients will also receive advanced hemodynamic monitoring with the MostCare Up device and clinical management will follow current guidelines and treating physicians' decisions. The study aims to describe immediate changes in exhaled gas metrics after common resuscitation maneuvers and to test agreement between exhaled and blood-based measurements.

Why it matters

Who can join: the full rules

Inclusion Criteria:

Hypotension (MAP\< 65mmHg or sudden drop in MAP \> 15 mmHg) and one of the following conditions:

* Heart rate \> 120 bpm
* Urinary output \< 0.5 ml/kg/h for at least two hours
* Lactate \> 2 mmol/L

Exclusion Criteria:

* Urgent need for surgery
* Urgent need for veno-arterial ECMO or severe hemodynamic instability
* Consistent risk of imminent death
* Severe ARDS or severe respiratory failure (p/F \< 100 mmHg) and/or FiO2\>0.8
* Severe heart failure (NYHA 4 and/or EF\<25%)
* Need for intermittent or continuous renal replacement therapy (IRRT or CRRT)
* Anemia defined as Hb\<8 g/dL
* VO2 variability \< 5% throughout ten minutes of stabilization before procedure start
* Intraabdominal hypertension, defined as intraabdominal pressure \> 18 mmHg
* Pregnancy
* Withdrawal or refuse of informed consent
* Terminal disease
* Do-not-resuscitate order.

Where it's running

• Policlinico Universitario Fondazione Agostino Gemelli IRCCS
  Roma, Italy Recruiting

Study contacts

• Study coordinator: Antonio M Dell'Anna
• Email: antoniomaria.dellanna@policlinicogemelli.it
• Phone: +39 0630154490

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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.