Trial Investigating Personalized Blood Pressure Targets Using Central Venous Pressure in Adults With Cardiogenic Shock

What this Trial Is About

This research aims to evaluate personalized blood pressure management in adults experiencing cardiogenic shock, a dangerous condition where the heart cannot pump enough blood, leading to organ problems and high risk of death. The study focuses on whether adjusting mean arterial pressure MAP targets based on central venous pressure CVP can improve organ function and survival compared to standard MAP targets. Cardiogenic shock currently has a poor outlook, and finding the best blood pressure goal is critical to improving outcomes. Participants will be randomly assigned to one of two groups. One group will receive personalized MAP management where the target MAP is adjusted by adding the measured CVP to a baseline, aiming for an effective perfusion pressure of 65 mmHg, with limits set between 65 mmHg plus CVP and 90 mmHg plus CVP. After 48 hours, if tissue perfusion improves, MAP targets may be lowered. The other group will receive standard care targeting a MAP of 65 to 70 mmHg, following international guidelines. CVP is measured using a catheter placed in the superior vena cava. During the study, researchers will monitor participants for up to 28 days, checking outcomes such as mortality, use of mechanical heart support, kidney failure, and other organ functions. Assessments include vital signs, organ failure scores, blood tests, and complications like arrhythmias or bleeding. The study collects data at specific times after randomization to evaluate survival, length of hospital stay, and need for treatments like dialysis or ventilation. Overall, the study seeks to determine if personalized blood pressure targets can better protect organs and improve survival in cardiogenic shock.

Personalisation of Mean Arterial Pressure in Adult Patients With Cardiogenic Shock