We're trying to launch a study that looks at requirement of pressers, which vasoconstrict, for ICU patients with physical interventions to raise pressure, but some of these patients are under sedation, which vasodilate. If a patient in the ICU requires more sedation, but needs to maintain certain blood pressure goal, they will need to have additional pressers. The issue is that the physical intervention should hopefully raise blood pressure and lessen the need for pressers; however, if during the physical intervention the patient experiences agitation they may need more sedating medication and in turn might crash or become critically unstable without the addition of pressers, which would skew our data. On top of that, each person differs in the amount of sedative that they would respond to, and in turn, how much presser they respond to. Forgive me for being narrow minded or if this question seems asinine, but I just can't figure out a way to truly measure the effect of the physical intervention on blood pressure if chemical intervention changes during the measurement. I assumed you'd have to normalize values in some capacity from each individual patient, as there is a scale of "expected" blood pressure drops and elevations that correspond to each drug. I thought about testing prior to physical intervention the drop in each patient's blood pressure with sedative and normalizing the individual values to a scale, same with the pressers, but I didn't know if there were a better way, re study design.
Thanks so much!