RecruitingNCT07653659

Hemodynamic Effects of Norepinephrine Reduction on Critical Closing Pressure in Distributive Shock

Changes in Critical Closing Pressure and Derived Hemodynamic Parameters Following Norepinephrine Dose Reduction in Distributive Shock Patients: a Prospective Observational Study

Sponsor

Peking Union Medical College Hospital

Enrollment

30 participants

Start Date

Sep 1, 2025

Study Type

OBSERVATIONAL

Conditions

Critical Illness Distributive shock Hemodynamic Assessment

Summary

This study prospectively observes changes in critical closing pressure (Pcc) and derived hemodynamic parameters in mechanically ventilated distributive shock patients when clinically indicated norepinephrine dose reduction is performed by the attending physician. Pcc is measured before and 30 minutes after dose reduction using a stepwise inspiratory hold maneuver via PiCCO monitoring.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

Adult distributive shock patients aged ≥18 years;
Receiving norepinephrine infusion with MAP in the 75-85 mmHg range;
PiCCO catheter in situ;
Under mechanical ventilation;
Clinically indicated norepinephrine dose reduction per attending physician judgment.

Exclusion Criteria4

Significant cardiac arrhythmia affecting CO measurement reliability;
Contraindication to airway plateau pressure maneuver;
Active titration of other vasoactive agents within 30 minutes prior to measurement;
Hemodynamic instability making it impossible to reduce norepinephrine dose.

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

OTHERNot applicable- observational study

Observation of hemodynamic parameters before and after clinically indicated norepinephrine dose reduction. No investigator-initiated intervention was performed.