Hemodynamic Evaluation Using Microcirculation for Early Treatment of Septic Patients (HEMOCAP)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Sepsis and its most serious form, septic shock, are a public health problem. Sepsis is defined by the presence of organ failure, including acute circulatory failure, which combines hypovolemia, vasoplegia and cardiac dysfunction. Vascular filling is therefore a pillar of the management of septic patients to correct hypovolemia and improve perfusion and tissue oxygenation. Following numerous studies, the evaluation of peripheral microcirculation is becoming a clinical "trigger" making it possible to identify patients at risk, particularly in emergency department. In a meta-analysis, it has been showed that alterations in microcirculatory perfusion predict deterioration and mortality during severe infections. Currently, no interventional study has evaluated the impact of measuring microcirculatory perfusion (peripheral perfusion index and marbling) by nurses on patient prognosis through early initiation of vascular filling.
In this study, patients will be assessed hemodynamically using peripheral perfusion index and/or presence of mottling. If peripheral perfusion index > 3s and/or presence of marbling a first vascular filling test of 500 cc over 30 minutes will be started after a medical control.
Patient will be followed up 7 days to determine outcome.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Anaelle NARDOT-SUCHAUD
- Phone Number: 0519761835
- Email: Anaelle.NARDOT-SUCHAUD@chu-limoges.fr
Study Locations
-
-
-
Brivé, France, 19100
- Recruiting
- Brive Hospital
-
Principal Investigator:
- Pierrick BARDOU
-
Guéret, France, 23000
- Recruiting
- Guéret Hospital
-
Principal Investigator:
- Amaury GALAUD
-
Limoges, France, 87000
- Recruiting
- Limoges University Hospital
-
Principal Investigator:
- Manon DUMOLARD
-
Saint-Junien, France, 87200
- Recruiting
- Saint Junien Hospital
-
Principal Investigator:
- Morgan GAURIAT
-
Tulle, France, 19012
- Recruiting
- Tulle Hospital
-
Principal Investigator:
- Philippe DUPUY
-
Ussel, France, 19200
- Recruiting
- Ussel Hospital
-
Principal Investigator:
- Cyril MOESCH
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years
- Admitted to the Emergency Department for suspected Sepsis for less than 6 hours according to international Sepsis-3 definitions (high probability of infection defined by a fever greater than or equal tol to 38.3°C with a suspected infectious source + Score NEWS 2 greater than or equal to 2)
- Affiliated to a social security system
- Having agreed to participate in this study
Exclusion Criteria:
- Patient with arterial hypotension (SBP ≤ 100 mmHg) on admission
- Patient having already received a 500mL filling test over 30 minutes
- Patients moribund according to the investigator
- Pregnancy or breastfeeding
- Patient under guardianship, curatorship or safeguard of justice
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention arm
As soon as an eligible patient is identified by the nurse, in addition to the classic hemodynamic parameters measured in all patients, a measurement of the peripheral perfusion index (from 1 sec to 10 sec) and marbling assessment (scale from 0 to 5) will be performed.
This measurement will be validated by the senior doctor of the Sepsis Department.
When the peripheral perfusion index will be ≥ 3 sec and/or the marbling score ≥ 1, a first vascular filling test of 500 cc over 30 minutes will be started, regardless of the value of the hemodynamic parameters.
|
in addition to the classic hemodynamic parameters measured in all patients, a measurement of the peripheral perfusion index (from 1 sec to 10 sec) and marbling assessment (scale from 0 to 5) will be performed
|
|
No Intervention: Control arm
Patients will benefit from treatment according to current standards of care
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number and proportion of patients presenting clinical deterioration during emergency care
Time Frame: between time of inclusion and 24 hours after
|
Clinical deterioration is defined by (composite criterion):
|
between time of inclusion and 24 hours after
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number and proportion of patients who received bundles (i) one hour and (ii) 3 hours of admission to the Emergency Department
Time Frame: from admission to the Emergency Department to 3 hours after
|
from admission to the Emergency Department to 3 hours after
|
|
Difference in SOFA score (≥ 2 points) between Hours 0 and Hours 24 (24h±6h)
Time Frame: between Hours 0 and Hours 24
|
between Hours 0 and Hours 24
|
|
Number and proportion of deaths on Day 7
Time Frame: from enrollement to the end of the patient participation at Day 7
|
from enrollement to the end of the patient participation at Day 7
|
|
Number and proportion of patients with hydrostatic pulmonary oedema (cardiogenic or volume overload) or receiving diuretic treatment during emergency care
Time Frame: from enrollment to the end of the subject participation at day 7
|
from enrollment to the end of the subject participation at day 7
|
|
The correlation of the peripheral perfusion index measurement (pathological : yes/no) between the nurse and the emergency physician
Time Frame: hour 0
|
hour 0
|
|
Number and proportion of patients sent home, conventional hospitalization or intensive care
Time Frame: from enrollment to the end of the subject participation at day 7
|
from enrollment to the end of the subject participation at day 7
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 87RI24_0047 (HEMOCAP
- 2025-A00216-43 (Other Identifier: IDRCB)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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