Midodrine Hydrochloride in Early Sepsis

Inclusion Criteria:

Patients diagnosed with sepsis based on the old Sepsis criteria and meeting all of the following criteria will be considered eligible to participate in the study.

• Age greater than or equal to 18 years
• Able to safely tolerate medication either by mouth or feeding tube (i.e. absence of nausea or vomiting)
• Able to give consent for participation or have representative available
• Two or more blood pressure readings taken at least 15 minutes apart with mean arterial pressures, MAPs 70 or less
• Treating consultant agrees to the study plan

Exclusion Criteria:

Patients meeting any one of the following criteria will be excluded from participation:

• Women of child bearing age with the potential to become pregnant who do not have a clinically documented negative pregnancy test
• Current cardiogenic shock or known systolic heart failure with left ventricular ejection fraction (LVEF) < 30%
• Current bowel ischemia
• Recent Myocardial infarction within the past 3 months
• Current use of Monoamine Oxidase Inhibitors (MAOIs)
• Recent Stroke within the past 3 months
• Midodrine as a home medication
• Known allergy to Midodrine
• High dose vasopressor use (norepinephrine >0.25 mcg/kg/min)
• Lactate more than 8 mmol/L
• Contraindications to use: History of pheochromocytoma or thyrotoxicosis or glaucoma or ischemic bowel disease