I. Intervention group – targeted tissue perfusion (TTP) care: | |
Primary targets | |
Capillary refill time (CRT)/every hour | <3 s |
Skin mottling [17]/every hour | Absent |
Peripheral temperature/every hour | Warm |
Urine output/every hour | ≥0.5 mL/kg/h |
Arterial lactate [7]/per 2 h | <2.0 mmol/L |
Mean arterial pressure (MAP) | 50–65 mmHg (minimum as a safety limit) |
aIf previous hypertension [7] | a65–70 mmHg |
bIf oliguria <0.3 ml/kg [7] | b2-h trial 75–80 mmHg, |
If diuresis improves, continue for 2 h and re-evaluate | |
Secondary target | |
Continuous SvO2 [7], if available | >65 %c |
II. Control group – macrocirculatory targets-guided (MCG) standard care | |
Primary targets | |
Mean arterial pressure (MAP) [7] | 65–75 mmHg |
aIf previous hypertension [7] | a75–80 mmHg |
bIf oliguria <0.3 ml/kg | b2-h trial 85–90 mmHg |
If diuresis better, continue for 2 h and re-evaluate | |
Central venous pressure (CVP) [7] | 8–12 mmHg |
Adequate fluid therapy is indicated to restore clinical hypovolemia up to the recommended CVP level of 8–12 mmHg, if needed | |
Urine output [7] | ≥0.5 mL/kg/h |
Secondary target | |
Continuous SvO2 [7], if available | >65 %c |