Critical Care Ultrasound Oriented Shock Treatment in Intensive Care Unit: A Randomized Controlled Trial

Abstract Objective: To determine whether our established Pathophysiology and etiology treatment for shock based on critical ultrasonography (PESCUS) workflow is superior to standard care in the setting of Intensive Care Unit (ICU). Materials and Methods: This is a prospective randomized controlled study. Critically ill adult shock patients were assigned to critical care ultrasound oriented treatment (CUOT) group who received treatment designed for different phases of shock guided by PESCUS workflow or standard care (SC) group who received standard care without treatment guided by PESCUS workflow.Results: Of the 147 enrolled patients, 77 were assigned to the CUOT group and 70 to the SC group. There were no significant difference between the two groups at baseline. The ICU mortality in CUOT group was significantly lower (29.9% vs. 45.7%, P=0.047). The CUOT group received significantly less fluid than SC group in the stabilization and de-escalation phases. The median duration of stabilization and de-escalation phase of shock in CUOT group was 35.0 [IQR 19.3-59.8] hours compared with 60.0[IQR 24.0-78.0] hours in SC group, p=0.024). Conclusions: Our study suggests utilization of PESCUS workflow can potentially improve ICU outcome in shock patient and avoid unnecessary fluid overload during shock recovery phase. Trial registration: Critical Care Ultrasound Oriented Shock Treatment in ICU, (28/03/2017) NCT03093987，Registered, Retrospectively registered .