Effects of Increasing Mean Arterial Pressure on Renal Function in Patients With Shock and With Elevated Central Venous Pressure

The purpose of this study is to assess the effect of a higher mean arterial pressure on renal function for patients with shock and elevated central venous pressure.

Inclusion Criteria:Adult patients (≥ 18 years old )Arterial hypotension requiring the etablishment of catecholaminesNorepinephrine dose ⩾ 0.1µg/kg/min at the inclusionHigh central venous pressure ≥ 12mmHgCardiac output monitoring (PICCO or Swan Ganz)Exclusion Criteria:AnuriaPatient with an emergency indication of renal replacement therapy (severe hyperkalemia, severe metabolical acidosis with pH <7.15, acute pulmonary edema due to fluid overload resulting in severe hypoxemia, serum urea concentration > 40 mmol/l)Pregnant, lactating or parturient womanPatient deprived of liberty by judicial or administrative decisionPatient with psychiatric compulsory carePatient subject to legal protection measuresPatients with do-no-reanimate order or withdrawal of life sustaining support