Comparing CO2 Gap-Guided and Lactate-Guided Early Treatment Strategies for Adults with Septic Shock in Intensive Care

What this Trial Is About

Sepsis is a serious condition caused by the bodys uncontrolled response to infection, leading to organ failure and potentially death. Septic shock, the most severe form, causes blood vessels to widen and leak, resulting in low blood pressure and poor oxygen delivery to tissues. Researchers are investigating whether guiding early treatment using the difference in carbon dioxide levels between venous and arterial blood CO2 gap can improve survival compared to the current practice of using blood lactate levels. Participants will be randomly assigned to one of two groups one group will have their treatment guided by maintaining a low CO2 gap, with blood samples taken every 2 to 4 hours and treatment adjusted based on a specific protocol. The other group will receive treatment guided by lowering lactate levels by at least 20% during the same intervals, following established sepsis guidelines. Treatments include the use of medications like dobutamine and blood transfusions as needed. During the study, participants will be closely monitored for 28 days after starting treatment. Researchers will track survival as the main outcome and also assess other health measures daily up to 90 days. Blood samples, organ function scores, and treatment responses will be regularly evaluated to understand the effects of the two strategies on septic shock outcomes.

Veno-arterial Carbon Dioxide Partial Pressure Difference (CO2gap) for Early Resuscitation of Septic Shock