Norepinephrine Weaning Guided by the Hypotension Prediction Index in Vasoplegic Shock After Cardiac Surgery

What this Trial Is About

Researchers are studying patients who develop vasoplegic syndrome, a condition causing low blood pressure after cardiac surgery involving extracorporeal circulation. This condition is linked to increased risk after surgery, and current guidelines recommend norepinephrine as a first treatment to reduce complications. However, too much or prolonged use of norepinephrine can also cause harm. This trial evaluates whether using a new monitoring device, the Acumen IQ, which predicts low blood pressure episodes, can improve how norepinephrine is reduced in these patients. The study compares two groups of patients after cardiac surgery: one group follows a standard norepinephrine weaning protocol based on maintaining mean arterial pressure (MAP) above 65 mmHg, while the other group uses the same protocol guided additionally by the Hypotension Prediction Index (HPI) from the Acumen IQ device. This device predicts arterial hypotension episodes by calculating HPI values and helps detect when patients are dependent on blood volume. The interventional treatment period lasts 72 hours, with follow-up visits at the end of the protocol, at hospital discharge, and 30 days after inclusion to collect clinical and biological data. Participants are monitored closely with arterial catheters to measure blood pressure and receive norepinephrine as needed. Researchers will track the duration of norepinephrine administration, frequency and duration of hypotensive episodes, fluid volumes given, and occurrences of complications such as stroke or kidney injury. The study lasts 30 days total to assess the clinical impact of the protocol, including mortality. The aim is to see if HPI guidance can safely reduce norepinephrine use and improve patient outcomes after cardiac surgery.

Norepinephrine Weaning Guided by the Hypotension Prediction Index in Vasoplegic Shock After Cardiac Surgery