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Impact of Systematic Point-of-Care Ultrasound Implementation on Clinical Outcomes and Survival in Septic Shock: A Retrospective Single-Center Cohort Study (SHOCK)

29. april 2026 opdateret af: Clinica Universidad de Navarra, Universidad de Navarra

Impact of Systematic Implementation of Point-of-Care Ultrasound on Clinical Course and Survival in Patients With Septic Shock: A Retrospective Single-Center Cohort Study

This study aims to evaluate the clinical impact of the systematic implementation of point-of-care ultrasound (POCUS) in the management of patients with septic shock in the intensive care unit (ICU).

Septic shock is associated with high morbidity and mortality, and its management requires timely and accurate hemodynamic assessment. Traditional monitoring methods have limitations in evaluating cardiac function, fluid responsiveness, and tissue perfusion. POCUS provides real-time, bedside, non-invasive assessment that may improve clinical decision-making.

This is a retrospective, single-center cohort study comparing two time periods: a pre-implementation cohort (2016-2019) and a post-implementation cohort (2022-2025), excluding the COVID-19 pandemic period. The primary objective is to assess whether the implementation of POCUS is associated with an improvement in early organ dysfunction, measured as the change in SOFA score at 48 hours (delta SOFA). Secondary outcomes include mortality at 28, 60, and 90 days, incidence of acute kidney injury, duration of organ support therapies, and length of ICU and hospital stay.

Studieoversigt

Status

Afsluttet

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

200

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Spanien
    • Navarre
      • Pamplona, Navarre, Spanien, 31008
        • Clinica Universidad de Navarra

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients admitted to the intensive care unit with septic shock in a tertiary care hospital, identified through retrospective review of electronic medical records.

Beskrivelse

Inclusion Criteria:

  • Age ≥18 years
  • Admission to the intensive care unit (ICU) with a clinical diagnosis or suspicion of septic shock
  • Microbiological confirmation of infection during clinical course
  • Availability of data required to calculate SOFA score at ICU admission and at 48 hours

Exclusion Criteria:

  • ICU admissions during the period 2020-2021
  • Readmissions related to the same episode of septic shock
  • Missing data required for SOFA score calculation
  • Patients with limitation of life-sustaining therapies

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Pre-POCUS Cohort
Patients admitted to the ICU with septic shock between January 2016 and December 2019, before the systematic implementation of point-of-care ultrasound (POCUS).
Post-POCUS Cohort
Patients admitted to the ICU with septic shock between January 2022 and December 2025, after the systematic implementation of point-of-care ultrasound (POCUS).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in SOFA score at 48 hours (Delta SOFA)
Tidsramme: Baseline (ICU admission) and 48 hours after ICU admission
Difference between the Sequential Organ Failure Assessment (SOFA) score at ICU admission and at 48 hours.
Baseline (ICU admission) and 48 hours after ICU admission

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
28-day mortality
Tidsramme: Up to 28 days after ICU admission
All-cause mortality within 28 days from ICU admission
Up to 28 days after ICU admission
60-day mortality
Tidsramme: Up to 60 days after ICU admission
All-cause mortality within 60 days from ICU admission
Up to 60 days after ICU admission
90-day mortality
Tidsramme: Up to 90 days after ICU admission
All-cause mortality within 90 days from ICU admission
Up to 90 days after ICU admission
Incidence of acute kidney injury
Tidsramme: From ICU admission to ICU discharge
Occurrence of acute kidney injury during ICU stay
From ICU admission to ICU discharge
Vasopressor-free days up to day 28
Tidsramme: From ICU admission to day 28
Number of days alive and free from vasopressor support within the first 28 days after ICU admission
From ICU admission to day 28
Mechanical ventilation-free days up to day 28
Tidsramme: From ICU admission to day 28
Number of days alive and free from mechanical ventilation within the first 28 days after ICU admission
From ICU admission to day 28
Renal replacement therapy-free days up to day 28
Tidsramme: From ICU admission to day 28
Number of days alive and free from renal replacement therapy within the first 28 days after ICU admission
From ICU admission to day 28
ICU length of stay
Tidsramme: From ICU admission to day 28
Length of stay in the intensive care unit
From ICU admission to day 28
Hospital length of stay
Tidsramme: Through hospital discharge, an average of 28 days
Total length of hospital stay
Through hospital discharge, an average of 28 days
Change in qSOFA score at 24 and 72 hours
Tidsramme: Baseline (ICU admission), 24 hours, and 72 hours
Change in quick Sequential Organ Failure Assessment (qSOFA) score at 24 and 72 hours from ICU admission
Baseline (ICU admission), 24 hours, and 72 hours

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Clinica Universidad de Navarra, Universidad de Navarra

Efterforskere

  • Ledende efterforsker: Alvaro Casado Iglesias, MD, Clinica Universidad de Navarra

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2016

Primær færdiggørelse (Faktiske)

31. december 2025

Studieafslutning (Faktiske)

31. marts 2026

Datoer for studieregistrering

Først indsendt

17. april 2026

Først indsendt, der opfyldte QC-kriterier

29. april 2026

Først opslået (Faktiske)

4. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • POCUS-SHOCK

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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