Corporeal Compression at the Onset of Septic shock (COCOONs): a compression method to reduce fluid balance of septic shock patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-08-09

AUTHORS

Auguste Dargent, Audrey Large, Agnès Soudry-Faure, Jean-Marc Doise, Caroline Abdulmalak, Lysiane Jonval, Pascal Andreu, Jean-Baptiste Roudaut, Sébastien Prin, Pierre-Emmanuel Charles, Didier Payen, Jean-Pierre Quenot

ABSTRACT

Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There is currently no treatment for capillary leak, which is mainly responsible for high positive fluid balance (FB) in sepsis. We hypothesized that increasing interstitial pressure with extensive corporeal compression would reduce FB. The objective of this study was to evaluate the feasibility, efficacy, and safety of a compression treatment during sepsis. This pilot, two-center, single-arm trial enrolled critically ill, non-surgical, septic patients receiving mechanical ventilation. The therapeutic intervention was the early application of compression bandages on more than 80% of the body surface. The primary outcome was negative net FB on day 7. The primary endpoint was reached in 29 of 45 patients (64%) with available data, for a planned objective of 26. By day 4, cumulative FB was 7280 ml [3300–9700]. SOFA- and aged-matched patients from a historical cohort had a significantly higher FB at 1, 2 and 7 days. Tolerance was good, although low-stage pressure ulcers were observed in 16 patients (26%). No effect on intra-abdominal pressure or respiratory plateau pressure was observed. In conclusion, corporeal compression demonstrated potential efficacy in limiting FB during septic shock, with acceptable feasibility and tolerance. More... »

PAGES

11566

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41598-019-47939-2

DOI

http://dx.doi.org/10.1038/s41598-019-47939-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1120211589

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31399609


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