Comparing Fluid Resuscitation Strategies to Prevent Fluid-related Harm in Adults with Septic Shock

What this Trial Is About

Researchers are evaluating two different fluid resuscitation strategies in patients with septic shock who need additional fluids. The study aims to compare a strategy that uses fluid intolerance signals to guide fluid administration with the standard care approach. The goal is to assess fluid-induced harm by monitoring changes in lung, heart, and kidney function, while also checking how well hypoperfusion improves during a 6-hour study period. Participants will be randomly assigned to one of two groups. The intervention group will receive fluids guided by real-time ultrasound and other fluid intolerance signals to limit harmful fluid overload. The control group will follow the usual care method, giving fluids based on responsiveness and hypoperfusion signs like capillary refill time. Both groups will be managed according to standard ICU practices including mechanical ventilation and sedation. During the study, patients will be monitored closely with various tests including lung ultrasound, heart and kidney biomarkers, capillary refill time, and arterial lactate levels. The main outcome measured is the change in oxygenation PaO2FiO2 ratio over 6 hours. Patients will also be followed for 28 days to assess longer-term outcomes. Safety and effectiveness in resolving hypoperfusion will be tracked throughout the study period.

Fluid Intolerance Signals as Safety Limits to Prevent Fluid-induced Harm During Septic Shock Resuscitation