PRESSURE
Research type
Research Study
Full title
PRESSURE: PRotocolised Evaluation of permiSSive blood pressure targets versus Usual caRE. Evaluating the clinical and cost effectiveness of using a permissive blood pressure target to guide titration of vasoactive drugs in critically ill children with hypotension.
IRAS ID
289545
Contact name
David Inwald
Contact email
Sponsor organisation
Cambridge University Hospital NHS Foundation Trust
ISRCTN Number
ISRCTN20609635
Duration of Study in the UK
3 years, 6 months, 27 days
Research summary
When children are in intensive care, their blood pressure can fall. A low blood pressure (hypotension) can be dangerous, even life threatening. It can cause damage to the brain and other organs. Many intensive care treatments are used to increase blood pressure. These include intravenous fluids and drugs to make the heart pump harder. However, these treatments also have side-effects and complications. Currently, most doctors aim to achieve a blood pressure in the normal range for age. However, recent research in adults shows that it may be safer not to push blood pressure all the way back up to normal, but simply to avoid very low pressures. Unfortunately, in children, there is no clear evidence on which to base practice.
The Paediatric Intensive Care Society and the Intensive Care National Audit & Research Centre (ICNARC), have developed the PRotocolised Evaluation of permiSSive hypotension versus Usual caRE (PRESSURE) study, which aims to find out the best blood pressure target to use for children in paediatric intensive care units (PICUs). We plan to conduct a clinical trial testing a lower blood pressure target (depending upon age) in children with hypotension against current usual practice. In common with other recent emergency trials in children, we will use a ‘deferred consent’ approach where permission to continue with the study is sought from parents as soon as possible after the emergency care has been provided. To find out which treatment is best, we will compare the amount of time children need support for their breathing and survival in intensive care between the two groups. We will also look at survival and child development after leaving PICU, as well as the total costs of the treatments.
PRESSURE will help us determine the best blood pressure target to use for children with low blood pressure in PICU.REC name
East of England - Cambridge South Research Ethics Committee
REC reference
21/EE/0084
Date of REC Opinion
10 May 2021
REC opinion
Further Information Favourable Opinion