Personalized mean arterial pressure targets guided by central venous pressure for adults with cardiogenic 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 randomized interventional study compares a personalized MAP strategy that adjusts targets using measured or estimated central venous pressure (CVP) versus standard MAP management in adults with cardiogenic shock. Eligible patients are adults with cardiogenic shock (SCAI class ≥ C) who require inotropes/vasopressors and meet enrollment physiologic criteria. Patients are randomized early after presentation, and MAP is titrated in each arm according to the assigned strategy while monitoring organ function and hemodynamics. The study's main outcomes focus on organ dysfunction and survival during the acute shock period.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Aged ≥18 years
* Cardiogenic shock state, according to the consensus definition,
* SCAI (Society for Cardiovascular Angiography and Interventions) classification ≥ C
* Consent from the patient or close relative / trusted person or emergency inclusion procedure
* Benefiting fromciary of a social security scheme

Exclusion Criteria:

* Catecholamine infusion for more than 24 consecutive hours;
* CVP \< 5 mm Hg at inclusion;
* MAP \> 70 mmHg at inclusion;
* Chronic kidney disease stage G4 (defined by an eGFR between 15-29 ml/min/1.73 m²) or G5 (defined by an eGFR less than 15 ml/min/1.73 m²) according to the KDIGO CKD classification at inclusion;
* Chronic dialysis or presence of renal replacement therapy criteria at inclusion ;
* Recovered cardiopulmonary arrest within 7 days prior to inclusion;
* Patient already on mechanical circulatory support at inclusion before enrollment (patients who receive support after inclusion will not be excluded);
* Primary diagnosis of tamponade, pulmonary embolism, or septic shock;
* Hypersensitivity to norepinephrine tartrate or to any of the following excipients: sodium chloride, hydrochloric acid or sodium hydroxide water for injectable preparations;
* Absence of central venous access;
* Known pregnancy or current breastfeeding;
* Under legal guardianship, curatorship, or judicial protection.

Where it's running

• Hôpital Henri Mondor
  Créteil, France Recruiting
• CMC Ambroise Paré - Hartmann
  Neuilly-sur-Seine, France Recruiting
• CHU d'Amiens-Picardie
  Amiens, France Not yet recruiting
• Hôpital Privé Jacques Cartier
  Massy, France Not yet recruiting
• CHU d'Orléans
  Orléans, France Not yet recruiting
• Hôpital Lariboisière
  Paris, France Not yet recruiting

Study contacts

• Study coordinator: Armand MEKONTSO DESSAP, MD
• Email: armand.dessap@aphp.fr
• Phone: + 33 1 45 17 85 06

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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.