[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Regione del Veneto - AULSS n. 7 Pedemontana\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":47},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,1,0,[8],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":28,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":35,"lastUpdatePostDateStruct":36,"startDateStruct":39,"completionDateStruct":41,"leadSponsor":43,"locationsCount":46},"100659262","non-invasive-hemodynamic-optimization-of-sepsis-in-internal-medicine-a-randomized-study-comparing-therapy-guided-by-non-invasive-hemodynamic-indices-versus-standard-of-care-100659262",false,"NCT07863323","Non-invasive Hemodynamic Optimization of Sepsis in Internal Medicine: a Randomized Study Comparing Therapy Guided by Non-invasive Hemodynamic Indices Versus Standard of Care.","Ottimizzazione Emodinamica Non-invasiva Della Sepsi in Medicina Interna: Studio Randomizzato di Confronto Tra Terapia Diretta Agli Indici Emodinamici Non-invasivi Versus Standard di Cura. Codice Protocollo: EMODINAMICA_SEPSI","Inclusion Criteria:\n\n* Provision of specific informed consent;\n* Confirmed or suspected diagnosis of sepsis, defined according to the latest SSC guidelines as: \"the presence of a clear or suspected infection with life-threatening organ dysfunction caused by a dysregulated host response to infection indicated by a SOFA (Sequential Organ Failure Assessment) score ≥ 2\";\n* Patients of both sexes, aged 18 years or older;\n* Patients evaluated in the Emergency Department for suspected infection requiring hospital admission, at the General Medicine ward of Ospedale Alto Vicentino in Santorso (VI, Italy) or the Emergency Medicine ward of the Policlinico Universitario of Pisa (Italy).\n\nExclusion Criteria:\n\n* Stay in the Emergency Department of more than six hours, considered as the time between ED admission and ward admission;\n* Administration of more than 1000 cc of crystalloid therapy in the three hours prior to patient arrival in the ward;\n* Any admission from a facility or ward other than the Emergency Department;\n* Sepsis related to an ongoing hospital stay or any sepsis not fitting the definition of community-acquired infection;\n* Previous hospital admission within four weeks prior to ED access;\n* Sepsis related to trauma;\n* Presence of severe oncological disease with life expectancy less than 3 months at enrollment;\n* Active major bleeding;\n* Dialysis therapy;\n* Suspected or confirmed pregnancy;\n* Age under 18 years;\n* Patients who do not provide informed consent to the study.","ALL","18 Years",{"count":19,"type":20},430,"ESTIMATED","INTERVENTIONAL",[23],"NA","Background and Rationale Sepsis affects 20 to 30 million people globally each year, with an estimated 48.9 million cases in 2017. Despite medical advances, it still carries a high risk of death. Since sepsis progresses rapidly, early treatment is essential. This includes not only starting antibiotics quickly but also managing fluid levels effectively. Research suggests that in sepsis, fluid problems are often due to poor distribution in the body rather than an actual lack of fluids.\n\nCurrently, fluid and blood pressure management is often based only on monitoring arterial pressure, which may not provide a full picture of what's happening in the patient's circulatory system. More advanced indicators like Stroke Volume, Cardiac Output, and Peripheral Vascular Resistance can offer better guidance to optimize treatment and improve outcomes.\n\nNew non-invasive devices such as NICaS (Non-Invasive Cardiac System) make it easier and faster to monitor these values. NICaS uses electrical impedance technology and is approved by both the FDA and CE. It is easy to use, does not require specialized training, and allows for a more personalized and accurate treatment approach by tracking key heart and circulation parameters in real time.\n\nPrimary Objective\n\nThe main goal of this study is to compare two treatment strategies for patients with sepsis admitted to medical wards, and see which one leads to better survival:\n\n* Fluid and\u002For vasopressor therapy guided by non-invasive hemodynamic monitoring (using NICaS), based on values like Stroke Volume, Cardiac Power Index, and Peripheral Vascular Resistance.\n* Standard fluid therapy based on the international Surviving Sepsis Campaign (SSC) guidelines.\n\nSecondary Objectives\n\n* Use of vasopressors: Check which strategy leads to less frequent use of vasopressor drugs and shorter treatment duration with them.\n* Kidney function: See which method is linked to fewer cases needing dialysis or kidney support.\n* Timing of vasopressors: Understand if giving vasopressors earlier leads to better short- and mid-term outcomes, such as lower death rates after 30 days, fewer ICU admissions, and shorter hospital stays.\n* Albumin levels and circulation: Track how blood albumin levels change with circulation status, to see if there's a link with fluid leakage (capillary leak) and risk of death.\n* Fluid balance: Analyze how fluid gains and losses relate to changes in heart and circulation measurements.\n* Microcirculation: Test if adding signs of small vessel (microcirculation) issues to the main heart and blood flow indicators improves predictions of how patients will do.\n* Prediction scores: Investigate whether combining NICaS readings with common scoring systems like SOFA or APACHE helps doctors predict patient outcomes more accurately.\n* Time to stability: Compare how quickly patients in each treatment group recover to a stable condition. According to Rosenthal and Kavic's criteria, a patient is considered stable when: -Their illness is improving -There's low risk of getting worse again - Organ support is stable - There's little chance of new problems arising - There are no major complications.\n\nConclusion This study aims to evaluate whether a more personalized approach using real-time, non-invasive hemodynamic monitoring can lead to better outcomes in septic patients compared to standard care. If successful, this method could help reduce deaths, complications, and treatment costs in sepsis management.",[26,27],"Sepsis","Septic Shock",[29,30,31,32,33],"sepsis","septic shock","non invasive hemodynamics","fluid therapy","vasopressors","RECRUITING","2026-10-01",{"date":37,"type":38},"2026-10-07","ACTUAL",{"date":40,"type":38},"2025-06-03",{"date":42,"type":20},"2026-11",{"name":44,"class":45},"Regione del Veneto - AULSS n. 7 Pedemontana","OTHER",2,""]