Norepinephrine Titration in Sepsis-Induced Encephalopathy
Author Information
Author(s): Salem Mai Salah, Abosabaa Motaz Amr, Abd El Ghafar Mohamed Samir, EI-Gendy Hala Mohey EI-Deen Mohamed, Alsherif Salah El-din Ibrahim
Primary Institution: Tanta University Hospitals
Hypothesis
Does individualized hemodynamic management via the transcranial Doppler pulsatility index improve outcomes in sepsis-induced encephalopathy patients?
Conclusion
Individualizing hemodynamic management via the TCD pulsatility index did not significantly reduce mortality but improved Glasgow coma scale outcomes and reduced episodes of cerebral hypoperfusion.
Supporting Evidence
- ICU mortality percentage was not significantly different between the two groups (p=0.174).
- Significant increase in MAP at the end of norepinephrine infusion in the TCD group (p=0.002).
- GCS score at ICU discharge was significantly higher in the TCD group (p=0.014).
- Episodes of cerebral hypoperfusion were significantly lower in the TCD group (p=0.018).
Takeaway
This study looked at how adjusting blood pressure based on brain blood flow can help patients with a serious brain condition caused by sepsis. It found that while it didn't save more lives, it did help patients feel better.
Methodology
A prospective, single-center randomized controlled trial comparing TCD pulsatility index-guided norepinephrine titration to standard MAP-guided management in 112 patients with sepsis-induced encephalopathy.
Limitations
Single-center trial with a relatively small sample size; results may not be generalizable.
Participant Demographics
Patients aged 18 years or older diagnosed with sepsis-induced encephalopathy with septic shock.
Statistical Information
P-Value
0.002
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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