About this trial
Septic shock is a leading cause of death worldwide despite intensive research efforts. Only a few interventions have been proven to be effective in improving patient-centered outcomes. Recent clinical trials have reported the safety and efficacy of remote ischemic postconditioning (RIPOST) in a variety of pathologies, including myocardial infarction, cardiac surgery, and stroke. While RIPOST was mainly tested in pathologies with low mortality rates, several follow-up studies of large randomized clinical trials in acute myocardial infarction and in patients undergoing coronary artery bypass surgery have reported significant decreases (\> 50%) in long-term mortality. Experimental studies and proof-of-concept clinical trials have also suggested the potential benefits of RIPOST on mortality in sepsis and septic shock. The present protocol aims to test whether this non-invasive, widely available, inexpensive, and innovative intervention can improve survival in septic shock.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 18 years
Hospitalized in intensive care unit for less than 24 hours
Septic shock (Sepsis-3 definition) evolving for less than 18 hours
Preliminary written informed consent obtained from the patient or his/her close relative, or use of the emergency procedure in accordance with local regulations
Disqualifiers
Contraindication of the use of a brachial pressure cuff on both arms
Cardiac arrest
Pregnancy or breast feeding
Participation in another interventional study
Trial design
Parallel
Treatments tested in this trial
Remote ischemic conditioning
Other interventionA brachial cuff is positioned around one arm of the patient. Remote ischemic conditioning consists of alternating inflations and deflations of the brachial cuff. Four cycles of ischemic conditioning (5-min brachial cuff inflation at 200 mmHg followed by 5-min cuff deflation) are started as soon as possible after inclusion. The intervention is repeated 12 and 24 hours after inclusion.
No intervention
Other interventionNo intervention will be performed in the conrol group
Treatment groups
Trial outcomes
Primary outcomes
All-cause mortality at day 90 after inclusion
Secondary outcomes
Functional recovery
Number of days alive after discharge at home by day 90
SF-36 (Short Form-36 Health Survey) questionnaire score
Quality of livre is evaluated by SF-36 (Short Form-36 Health Survey) questionnaire at day 90
Number of days alive without vasopressors
Sepsis-related Organ Failure Assessment (SOFA) score
The severity of multiple organ failure assessed by the Sepsis-related Organ Failure Assessment (SOFA) score
Sponsors and contacts
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