Efficacy of Targeted Abdominal Perfusion Pressure in Septic Shock

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    Bozyaka Training and Research Hospital
Updated on 16 May 2022
septic shock


Septic shock is a clinical condition that is defined as a subset of sepsis that causes very high mortality and morbidity.

Surviving sepsis campaign guideline states that the target mean arterial pressure should be 65 mmHg and above in septic shock patients. It is known that abdominal pressure increases and perfusion of intra-abdominal organs decreases in septic shock patients.

With this study, we aim to investigate the effects of targeted abdominal perfusion pressure (60 mmHg and above) on renal injury, reversal of renal injury, liver functions and ultimately mortality in patients with septic shock.


Patients diagnosed with septic shock according to "Surviving Sepsis Campaign Guidelines 2021" will be included in the study.

Groups will be formed after the measurement of intra-abdominal pressure (IAP). Those with IAP of less than 8 mmHg will be assigned to the control group and treated according to mean arterial pressure. Those with IAP greater than 8 mmHg will be divided into two groups by computer-generated randomization (via randomizer.org). One group (Group MAP) will be treated according to mean arterial pressure and the other group (Group APP) will be treated according to abdominal perfusion pressure. In Group APP, maximum arterial pressure will be targeted as 130/85 mmHg.

All patients will receive appropriate antibiotic therapy, fluid therapy and, vasopressor treatment as recommended in "Surviving Sepsis Campaign Guidelines 2021" and abdominal pressure measurement will be repeated every 12 hours.

Age, sex, body mass index, cause of sepsis and comorbidities of all patients will be recorded.

Patients will be followed for liver and kidney function tests, procalcitonin and lactate levels, daily SOFA (Sequential Organ Failure Assessment) calculations, length of stay (days), length of stay in mechanical ventilator (days), and 30 and 90 days mortality.

Condition Septic Shock, Septicemia, Intraabdominal Hypertension, Renal Injury
Treatment Crystalloid solutions, Vasopressor Agent, Invasive Blood Pressure Monitoring, Intra-Abdominal Pressure Monitoring, Abdominal Perfusion Pressure
Clinical Study IdentifierNCT05358912
SponsorBozyaka Training and Research Hospital
Last Modified on16 May 2022


Yes No Not Sure

Inclusion Criteria

Diagnosis of septicemia according to "Surviving Sepsis Campaign Guidelines 2021
Age lower than 18

Exclusion Criteria

Reason of admission: Cardiac arrest
Abdominal surgery in the past 90 days
Pre-diagnosis of end-stage renal disease
History of abdominal trauma
Body mass index of 30 and above
Trauma, bleeding or cerebrovascular event that causes increased intracranial pressure
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