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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)

2026年4月29日更新者：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.

研究概览

地位

完全的

条件

研究类型

观察性的

注册 (实际的)

200

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

西班牙
- Navarre
  - Pamplona、Navarre、西班牙、31008
    - Clinica Universidad de Navarra

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

成人
年长者

接受健康志愿者

不

取样方法

非概率样本

研究人群

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

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

团体/队列数

队列和干预

团体/队列
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).

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Change in SOFA score at 48 hours (Delta SOFA) 大体时间：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

次要结果测量

结果测量	措施说明	大体时间
28-day mortality 大体时间：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 大体时间：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 大体时间：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 大体时间：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 大体时间：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 大体时间：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 大体时间：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 大体时间：From ICU admission to day 28	Length of stay in the intensive care unit	From ICU admission to day 28
Hospital length of stay 大体时间：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 大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Clinica Universidad de Navarra, Universidad de Navarra

调查人员

首席研究员：Alvaro Casado Iglesias, MD、Clinica Universidad de Navarra

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2016年1月1日

初级完成 (实际的)

2025年12月31日

研究完成 (实际的)

2026年3月31日

研究注册日期

首次提交

2026年4月17日

首先提交符合 QC 标准的

2026年4月29日

首次发布 (实际的)

2026年5月4日

研究记录更新

最后更新发布 (实际的)