Early Administration of Norepinephrine in Sepsis (Tunisian Multicenter Randomized Trial)
The management of septic states includes, in addition to the specific treatment (antimicrobials and eradication of the source), a restoration of the hemodynamic disorders and assistance of the failing organs. In general, the restoration of hemodynamic disorders begins first with volume expansion, followed by the use of Noepinephrine (NE) when the target mean arterial pressure (MAP) is not reached after optimizing the intravascular volume. Recently, several studies have supported the interest of early NE on MAP, cardiac output and mortality. It is therefore tempting to restrict fluid administration even in the initial phase of hemodynamic management of severe sepsis by starting NE earlier.
• Age 18 or older.
• The patient or his/her legal representative has given informed consent in writing.
• Diagnosis of sepsis according to the definitions updated by the consensus of sepsis 3.
• Mean arterial pressure \< 65 mmHg