Shock, Septic
Conditions
Keywords
septic shock, shock, serotonin, kynurenine, tryptophan
Brief summary
Septic shock is a major cause of mortality and morbidity worldwide. Serotonin (5-HT) is released by activated platelets into the circulation, and is mediator of endothelial dysfunction. 5-HT metabolism is known in immune system via specific 5-HT receptor, also in effects on the peripheral nervous system. Kinetic of 5-HT, tryptophan, kynurenine, MAO activity and IDO activity in human septic shock was never investigated.
Interventions
None listed
Sponsors
Versailles Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age above or equal to 18 years * Strong presumption clinical sepsis * Need for mechanical ventilation * Body temperature above 38°C or below 36°C * Heart rate above 90 bpm * Systolic blood pressure of \<90mm Hg despite adequate fluid replacement or a need for vasopressors less than 3 hours * Presence of at least one of the following criteria: * Ratio of arterial oxygen tension over inspired fraction of oxygen of less than 300 mm Hg * Urinary output below 0.5 mL per kg of bodyweight per h or below 30 mL/h (for at least 1 h) * Arterial lactate concentration above 2 mmol/L * Consent signed
Exclusion criteria
* Age below 18 years * Pregnancy * Underlying disease with a poor prognosis, a life expectancy of less than 24 hours * Depression or melancholy * Neuropsychiatric diseases: Seizure, manic psychosis, Migraine, or Drug addiction * Neuroendocrine tumors * Obstructive cardiomyopathy or acute myocardial ischaemia * Pulmonary embolism * Advanced stage cancer, malignant haemopathy, or AIDS with a decision to withhold or withdraw aggressive therapies * Inclusion in another clinical trial * Patient who receive before inclusion one of the following treatment known to modify serotonin level: almotriptan, amitriptyline, amoxapine, citalopram, clomipramine, clozapine, desipramine, dihydroergotamine, dolasetron, dosulepin, doxepin, eletriptan, ergotamine, flunarizine, fluoxetine, fluvoxamine, granisetron, imipramine, indoramin, interferon Alfa, interferon alfacon-1, interferon beta, iproniazid, maprotiline, methysergide, mianserin, Milnacipran, mirtazapine, moclobemide, naratriptan, olanzapine, ondansetron, oxetorone, paroxetine, pizotifen, risperidone, sertraline, sumatriptan, tianeptine, trimipramine, tropisetron, venlafaxine,viloxazine, zolmitriptan. * No consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Kinetics of 5-HT, 5-HIAA, kynurenine, tryptophan, HVA, VMA, DOPAC, Oestradiol, Cotinine and vasopressors | Day-1, Day-2, Day-3, Day-7 and Day-14 |
Secondary
| Measure | Time frame |
|---|---|
| Mortality | 28-day |
Countries
France
Outcome results
None listed