Using midodrine to help critically ill patients reduce vasopressor use

Effectiveness of Midodrine as an Adjuvant to Norepinephrine in Weaning Critically Ill Patients From Vasopressors

This study is testing if adding midodrine can help critically ill patients who are stable on low doses of norepinephrine reduce their need for vasopressors.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 112 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Sohag University (other)
• Locations: 1 site (Sohag)
• Trial ID: NCT06930235 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness of midodrine as an additional treatment alongside norepinephrine to help critically ill patients wean off vasopressors. It involves comparing two groups: one receiving midodrine and the other not receiving it while reducing norepinephrine support. The goal is to determine if midodrine can facilitate a safer and more effective transition away from vasopressor dependency in patients with refractory hypotension. The study focuses on patients who have been stable on low doses of norepinephrine for over 24 hours.

Who should consider this trial

Good fit: Ideal candidates are critically ill patients with refractory hypotension on low doses of norepinephrine who are clinically stable.

Not a fit: Patients experiencing severe shock requiring high doses of vasopressors or those with contraindications to midodrine will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could improve the weaning process from vasopressors, potentially leading to better outcomes for critically ill patients.

How similar studies have performed: While there is limited information on similar studies, the use of adjuvant therapies in critical care settings has shown promise in other contexts.

Eligibility criteria

Inclusion Criteria:

* Patients with refractory hypotension on an intravenous vasopressor for more than 24 h but deemed clinically stable.
* Patients on noradrenaline support \<10 μg/min

Exclusion Criteria:

* Known allergy to midodrine.
* Severe shock state, as evidenced by multiple vasopressor infusions or high vasopressor requirement (i.e. noradrenaline \>10 μg/min)
* Patients with severe organic heart disease (e.g., heart failure, sever aortic stenosis), pregnancy, thyrotoxicosis or pheochromocytoma.
* Those with no enteral route available.

Where this trial is running

Sohag

• Sohag University Hospital — Sohag, Egypt (RECRUITING)

Study contacts

• Study coordinator: Mohammed K Elsayed, resident

Conditions: Shock